MELANIE DOMKAM FOMBANG (NPI# 1447779590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447779590 |
| Entity Type | Individual |
| Full Name | MELANIE DOMKAM FOMBANG |
| Practice Address |
9950 Memorial Blvd Humble TX 77338-4281 |
| Mailing Address |
7214 Foxbrook Dr Humble TX 77338-1440 |
| Practice Telephone | 2814466803 |
| Mailing Telephone | 7134940016 |
| Enumeration Date | 2017-09-10 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP134868 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1639165129 | 05 |
| Street Address |
9950 MEMORIAL BLVD |
| City | HUMBLE |
| State | TX |
| Zip Code | 77338-4281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639165129 | North Houston Respiratory Consultants Pa | Internal Medicine | 9950 Memorial Blvd, Suite 102, Humble, TX 77338-4282 | 2005-09-21 |
| 1477768141 | Madaiah Revana Md Pa | Internal Medicine | 9950 Memorial Blvd, Suite 201, Humble, TX 77338-4281 | 2007-05-14 |
| 1013997360 | Madaiah Revana | Internal Medicine | 9950 Memorial Blvd, Ste 201, Humble, TX 77338 | 2006-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033690 | Daniel, Max & Marcandrea, LLC | Optometrist | 9475 Fm 1960, Humble, TX 77338 | 2020-11-03 |
| 1942818240 | Karla Marize Howard | Nurse Practitioner | 18980 W. Memorial Dr. Suite 100 Plaza 2, Humble, TX 77338 | 2020-07-22 |
| 1902437981 | Houston Mint Dentistry, Pllc | Dentist | 9509 Fm 1960 Ste 200, Humble, TX 77338 | 2020-01-29 |
| 1053957514 | Sherrie Conn | Technician | 20430 Moon Walk Dr, Humble, TX 77338 | 2019-11-20 |
| 1235772450 | Madeline Rigler | Dietitian, Registered | 18980 N Memorial Dr Ste 100, Humble, TX 77338 | 2019-10-21 |
| 1982254025 | Daira Lynn Springer | Registered Nurse | 18980 W Memorial Dr., Suite 100, Humble, TX 77338 | 2019-09-19 |
| 1306494687 | Strategic Development & Instruction | Counselor | 9802 Farm To Market 1960 Bypass, Humble, TX 77338 | 2019-08-29 |
| 1124689732 | Caroline Elizabeth Le | Dentist | 9490 Farm To Market 1960 Bypass Rd W, Suite 700, Humble, TX 77338 | 2019-06-25 |
| 1699246181 | Deerbrook Asc LLC | Clinic/Center | 18450 Hwy 59 Suite 101-b, Humble, TX 77338 | 2018-12-10 |
| 1760950141 | Mckay Health Care LLC | Skilled Nursing Facility | 19279 Mckay Dr., Humble, TX 77338 | 2018-11-05 |
| Find all providers in zip 77338 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467012534 | Smartchoice Health & Wellness Clinic | Nurse Practitioner | 9025 N Sam Houston Pkwy E Ste 105, Humble, TX 77396-4399 | 2019-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740588 | Jessica Claudia Cazaubon | Nurse Practitioner | 13327 Crim Rd, Houston, TX 77049-3448 | 2020-11-04 |
| 1629679147 | Magdoleen Awad | Nurse Practitioner | 1602 Morning Dove Ct, Carrollton, TX 75007-1462 | 2020-11-02 |
| 1215536131 | Linnet Litakuli Nandwa | Nurse Practitioner | 6509 Sheerwater Rd, Arlington, TX 76002-3680 | 2020-10-21 |
| 1902405301 | Texas Suburban Visiting Physician Services | Nurse Practitioner | 2200 Smith Barry Rd, Pantego, TX 76013-5800 | 2020-10-19 |
| 1437757432 | Katie Jo Dixon | Nurse Practitioner | 4300 Speedway Unit 4775, Austin, TX 78765-2032 | 2020-10-12 |
| 1376140954 | Melissa Kujawski | Nurse Practitioner | 332 Enid Dr, Lewisville, TX 75056-5874 | 2020-10-06 |
| 1952908188 | Sari Alhaik | Nurse Practitioner | 411 Park Grove Dr Ste 620, Katy, TX 77450-1576 | 2020-10-01 |
| 1669089421 | Heather Ann Votion | Nurse Practitioner | 4501 S General Bruce Dr Ste 75, Temple, TX 76502-1466 | 2020-09-25 |
| 1245847318 | Xin Peng | Nurse Practitioner | 707 Walsh Hill Trl, Cedar Park, TX 78613-4855 | 2020-09-23 |
| 1194331470 | Clara Dornisha Green | Nurse Practitioner | 5847 Acacia Cir Apt 1816, El Paso, TX 79912-4881 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MELANIE DOMKAM FOMBANG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.