Basic Information
| Provider Information | |||||||||
| NPI: | 1780173468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FONHOUE | ||||||||
| FirstName: | BOREL | ||||||||
| MiddleName: | SEDIMEE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13523 HARGRAVE RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770703829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812064496 | ||||||||
| FaxNumber: | 2812064487 | ||||||||
| Practice Location | |||||||||
| Address1: | 13523 HARGRAVE RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770703829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812064496 | ||||||||
| FaxNumber: | 2812064487 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2018 | ||||||||
| LastUpdateDate: | 09/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | T9109 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.