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General NPI Number Information
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NPI Number | 1235561663
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Entity Type | Individual
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Provider Name | HENRY AKOH WANTCHAMI FNP
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Gender | Male
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 9709 BRUTON RD
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City | DALLAS
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State | TX
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Zip | 75217-2704
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Country | US
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Telephone | 972-288-2844
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Fax |
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Provider Business Mailing Address
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Address Line | 12377 MERIT DR STE 300
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City | DALLAS
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State | TX
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Zip | 75251-3126
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Country | US
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Telephone | 972-957-3000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP123816
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 760471
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License Number State | TX
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