Healthcare Provider Details

I. General information

NPI: 1023219862
Provider Name (Legal Business Name): AFUA S AGYARKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/21/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 FM 2920 RD STE A2
SPRING TX
77388-3111
US

IV. Provider business mailing address

4701 FM 2920 RD STE A2
SPRING TX
77388-3111
US

V. Phone/Fax

Practice location:
  • Phone: 281-729-6481
  • Fax:
Mailing address:
  • Phone: 281-729-6481
  • Fax: 832-232-5591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberM9779
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM9779
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: