Healthcare Provider Details

I. General information

NPI: 1477183242
Provider Name (Legal Business Name): ANEEKA AKHTAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE NM
87107-7002
US

IV. Provider business mailing address

11511 SHADOW CREEK PKWY
PEARLAND TX
77584-7298
US

V. Phone/Fax

Practice location:
  • Phone: 505-266-5565
  • Fax:
Mailing address:
  • Phone: 713-442-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA14801
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: