MR. Ephraim Tata Fombo, PMHNP-BC is a psychiatric/mental health nurse practitioner in San Antonio, TX with 8 years of experience. MR. Ephraim Tata Fombo, PMHNP-BC NPI is 1134368327. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
3031 W IH 10
ATTN: CREDENTIALING DEPT
SAN ANTONIO, TX
ZIP 78201-159
Phone: (210) 261-1000
Fax: (210) 731-8678
The NPI 1134368327 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 2/11/2009 and was last updated on 11/8/2016.