Individual
FABRICE LIONEL POUGOUE NGOMSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12041 DESSAU RD APT 2309, AUSTIN, TX 78754-1729
(501) 650-4707
Mailing address
12041 DESSAU RD APT 2309, AUSTIN, TX 78754-1729
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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