Provider Demographics
NPI:1033492434
Name:AKANKI-AHMAD, FEYISARA R (MD)
Entity Type:Individual
Prefix:DR
First Name:FEYISARA
Middle Name:R
Last Name:AKANKI-AHMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FEYISARA
Other - Middle Name:R
Other - Last Name:AKANKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3310 LIVE OAK, 3RD FLOOR
Mailing Address - Street 2:COPC ADMNISTRATION,
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:25204
Mailing Address - Country:US
Mailing Address - Phone:214-266-1256
Mailing Address - Fax:214-266-1256
Practice Address - Street 1:3310 LIVE OAK, 3RD FLOOR
Practice Address - Street 2:COPC ADMNISTRATION,
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:214-266-1256
Practice Address - Fax:214-266-1256
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine