Provider Demographics
NPI:1356839211
Name:LUFONG, COMFORT NANGEH
Entity Type:Individual
Prefix:
First Name:COMFORT
Middle Name:NANGEH
Last Name:LUFONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 MEDICAL CENTER DR APT 44201
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-0120
Mailing Address - Country:US
Mailing Address - Phone:214-771-5324
Mailing Address - Fax:
Practice Address - Street 1:3191 MEDICAL CENTER DR APT 44201
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-0120
Practice Address - Country:US
Practice Address - Phone:214-771-5324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220795164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse