Provider Demographics
NPI:1013028646
Name:ASAMOAH, OSEI KWAME
Entity Type:Individual
Prefix:
First Name:OSEI
Middle Name:KWAME
Last Name:ASAMOAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:OSEI
Other - Middle Name:KWAME
Other - Last Name:ASAMOAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2602 SAINT MICHAEL DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2387
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2602 SAINT MICHAEL DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2387
Practice Address - Country:US
Practice Address - Phone:903-999-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6506207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine