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1629756986
MERCIFUL EKONGMADEM EYONGEGBE
FORT WORTH, TX
NPI
1629756986
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA16986)
Enumeration Date
2023-07-07
Last Update Date
2023-07-15
Business Address
MERCIFUL EKONGMADEM EYONGEGBE PA-C
851 W TERRELL AVE
FORT WORTH, TX 76104-3161
Phone number: 817-756-7385
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Mailing Address
MERCIFUL EKONGMADEM EYONGEGBE PA-C
PO BOX 33434
FORT WORTH, TX 76162-3434
Phone number: 817-332-8346
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