Healthcare Provider Details

I. General information

NPI: 1114703139
Provider Name (Legal Business Name): KIDS GASTRO CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7790 W GRAND PKWY S STE 102
RICHMOND TX
77406-5830
US

IV. Provider business mailing address

7790 W GRAND PKWY S STE 102
RICHMOND TX
77406-5830
US

V. Phone/Fax

Practice location:
  • Phone: 832-553-0700
  • Fax: 832-345-5771
Mailing address:
  • Phone: 832-553-0700
  • Fax: 832-345-5771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: AMAKA ANULI AKALONU
Title or Position: PHYSICIAN
Credential: MD
Phone: 832-605-0227