Healthcare Provider Details

I. General information

NPI: 1730043415
Provider Name (Legal Business Name): MARIE NOEL KEHMIA FOKWANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 SAWDUST RD
SPRING TX
77380-2238
US

IV. Provider business mailing address

2511 CHAPEL CREEK CT
HOUSTON TX
77067-1289
US

V. Phone/Fax

Practice location:
  • Phone: 832-342-6750
  • Fax:
Mailing address:
  • Phone: 720-518-5530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: