Provider Demographics
NPI:1528328457
Name:NDONGKEH, ETIENNE NGONG (PHARMACIST)
Entity type:Individual
Prefix:
First Name:ETIENNE
Middle Name:NGONG
Last Name:NDONGKEH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 FM 1560 N
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-9604
Mailing Address - Country:US
Mailing Address - Phone:210-688-9160
Mailing Address - Fax:210-399-0584
Practice Address - Street 1:9050 FM 1560 N
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-9604
Practice Address - Country:US
Practice Address - Phone:210-688-9160
Practice Address - Fax:210-399-0548
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
TX61610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No374U00000XNursing Service Related ProvidersHome Health Aide