Healthcare Provider Details

I. General information

NPI: 1295094068
Provider Name (Legal Business Name): IJEOMA AKUNYILI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST SUITE JJL 430
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

PO BOX 1472
BELLAIRE TX
77402-1472
US

V. Phone/Fax

Practice location:
  • Phone: 281-224-7929
  • Fax:
Mailing address:
  • Phone: 281-224-7929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP2182
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD17302
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number25MA10804000
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA10804000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: