Healthcare Provider Details

I. General information

NPI: 1639032055
Provider Name (Legal Business Name): ANNOVA HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5526 CASTLE BROOK DR
SAN ANTONIO TX
78218-4705
US

IV. Provider business mailing address

5526 CASTLE BROOK DR
SAN ANTONIO TX
78218-4705
US

V. Phone/Fax

Practice location:
  • Phone: 401-617-4653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OYINDAMOLA STELLA AKINKUGBE
Title or Position: OWNER
Credential: APRN, FNP-C
Phone: 401-617-4653