Healthcare Provider Details

I. General information

NPI: 1164359576
Provider Name (Legal Business Name): ABDOUL TOBIAS SANKARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7733 L ST
RALSTON NE
68127-1833
US

IV. Provider business mailing address

7733 L ST
RALSTON NE
68127-1833
US

V. Phone/Fax

Practice location:
  • Phone: 531-710-6581
  • Fax: 402-702-1668
Mailing address:
  • Phone: 531-710-6581
  • Fax: 402-702-1668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: