Healthcare Provider Details

I. General information

NPI: 1558116665
Provider Name (Legal Business Name): SONYA EMMA DJIKENG ATSAGOU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S COULTER ST
AMARILLO TX
79106-1786
US

IV. Provider business mailing address

1400 S COULTER ST STE 3500
AMARILLO TX
79106-1786
US

V. Phone/Fax

Practice location:
  • Phone: 806-414-9608
  • Fax:
Mailing address:
  • Phone: 806-414-9650
  • Fax: 806-354-5626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: