Organization
JAP CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTINE NUBEA FOMBON (CEO)
(214) 718-9593
Entity
Organization
Contact information
Practice address
601 S GREAT SOUTHWEST PKWY STE 106, GRAND PRAIRIE, TX 75051-1057
(214) 718-9593
(817) 260-0891
Mailing address
2812 WESTOVER DR, GRAND PRAIRIE, TX 75052-8560
(214) 718-9593
(817) 260-0891
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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