Most Relevant Information
Provider Data
| NPI Number: | 1003464496 |
| Provider Name: | FOMUNDAM NEWNTON MBUH NP |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | AP142762 |
Most Important Dates
| Enumeration Date: | 08/28/2019 |
| Last Updated: | 08/28/2019 |
Provider Practice Location
4759 SOUTH FWY STE 101
FORT WORTH
TX
761153655
Practice Location Phone/Fax
| Phone: | 8173820005 |
| Fax: |
Provider Mailing Location
PO BOX 788
ALEDO
TX
760080788
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |
Suggested EMR
Family Practice EMR