Healthcare Provider Details

I. General information

NPI: 1275742017
Provider Name (Legal Business Name): ANGELA AKONYE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N SAN SABA SUITE 1068
SAN ANTONIO TX
78207-3154
US

IV. Provider business mailing address

315 N SAN SABA SUITE 1068
SAN ANTONIO TX
78207-3154
US

V. Phone/Fax

Practice location:
  • Phone: 210-696-2496
  • Fax: 210-704-4634
Mailing address:
  • Phone: 210-696-2496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberM3844
License Number StateTX

VIII. Authorized Official

Name: DR. ANGELA AKONYE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 210-696-2496