Provider Demographics
NPI:1932964483
Name:FRUEAN, ELIANE ALUMNIKANANA
Entity Type:Individual
Prefix:
First Name:ELIANE
Middle Name:ALUMNIKANANA
Last Name:FRUEAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 ARMY BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-2686
Mailing Address - Country:US
Mailing Address - Phone:210-683-3265
Mailing Address - Fax:
Practice Address - Street 1:3145 GARDEN AVE # 1728
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-7718
Practice Address - Country:US
Practice Address - Phone:210-683-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist