Healthcare Provider Details

I. General information

NPI: 1588581417
Provider Name (Legal Business Name): MRS. JULIENNE OUMBE YONZO EPSE KOMBILA JR.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MR. GUY SERGE NGOMBI KOMBILA JR.

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24010 SPRING WAY DR
SPRING TX
77373-8901
US

IV. Provider business mailing address

24010 SPRING WAY DR
SPRING TX
77373-8901
US

V. Phone/Fax

Practice location:
  • Phone: 832-873-0245
  • Fax:
Mailing address:
  • Phone: 832-873-0245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number025033
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: