Healthcare Provider Details

I. General information

NPI: 1043724537
Provider Name (Legal Business Name): JAMES NKANSAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 SHAVER ST
PASADENA TX
77506-4405
US

IV. Provider business mailing address

1828 LAKE LANDING DR
LEAGUE CITY TX
77573-7781
US

V. Phone/Fax

Practice location:
  • Phone: 713-534-6665
  • Fax:
Mailing address:
  • Phone: 281-728-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42935
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: