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General NPI Number Information
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NPI Number | 1861079329
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Entity Type | Individual
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Provider Name | CESAR PAULIN FODING FOTSO
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Gender | Male
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 404 TEALRIDGE CT
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City | DESOTO
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State | TX
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Zip | 75115-6338
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Country | US
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Telephone | 972-246-9466
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Fax |
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Provider Business Mailing Address
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Address Line | 404 TEALRIDGE CT
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City | DESOTO
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State | TX
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Zip | 75115-6338
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Country | US
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Telephone | 972-246-9466
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | 41577134
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License Number State | TX
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