Provider Demographics
NPI:1609245430
Name:KOUMFIEG, EDWIGE FLORE
Entity Type:Individual
Prefix:
First Name:EDWIGE
Middle Name:FLORE
Last Name:KOUMFIEG
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 1:24802 ALDINE WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-5926
Mailing Address - Country:US
Mailing Address - Phone:870-230-3658
Mailing Address - Fax:
Practice Address - Street 1:24802 ALDINE WFLD RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-5926
Practice Address - Country:US
Practice Address - Phone:281-288-1561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0815119363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily