Gaius B Fomuso
Case Manager/Care Coordinator in Mansfield, TX. Individual provider (NPI-1).
NPI number1982957106
StatusActive
Last updated in NPPESOct 25, 2012
Details
- NPI
- 1982957106
- Entity type
- Individual (NPI-1)
- Name
- Gaius B Fomuso
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 25, 2012
- Last updated
- Oct 25, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
203 Lorient DrMansfield, TX 76063-5572
Phone 214-256-6648
Mailing address
203 Lorient DrMansfield, TX 76063-5572
Phone 214-256-6648
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