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General NPI Number Information
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NPI Number | 1154208783
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Entity Type | Individual
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Provider Name | LATIFOU A AMOUSSA LNFA
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Gender | Male
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 305 W FM 1187 APT 534
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City | CROWLEY
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State | TX
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Zip | 76036-4092
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Country | US
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Telephone | 512-669-2128
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Fax |
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Provider Business Mailing Address
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Address Line | 305 W FM 1187 APT 534
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City | CROWLEY
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State | TX
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Zip | 76036-4092
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Country | US
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Telephone | 512-669-2128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 0012389
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License Number State | TX
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