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General NPI Number Information
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NPI Number | 1578790143
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Entity Type | Individual
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Provider Name | NAA SACKEY MD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 17201 I 45 S
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City | SHENANDOAH
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State | TX
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Zip | 77385-3311
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Country | US
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Telephone | 936-270-2631
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Fax |
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Provider Business Mailing Address
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Address Line | 8168 TRANQUIL LAKE WAY
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City | CONROE
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State | TX
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Zip | 77385-1124
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R2466
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License Number State | TX
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