Provider Demographics
NPI:1174303911
Name:ATABONG, AMINDEH NKEM
Entity type:Individual
Prefix:MR
First Name:AMINDEH
Middle Name:NKEM
Last Name:ATABONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31311 BROWN FERN DR
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-2282
Mailing Address - Country:US
Mailing Address - Phone:313-917-8304
Mailing Address - Fax:
Practice Address - Street 1:31311 BROWN FERN DR
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-2282
Practice Address - Country:US
Practice Address - Phone:313-917-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant