Provider Demographics
NPI:1043612120
Name:KAZEEM, UNAKEM ANNETTE
Entity Type:Individual
Prefix:
First Name:UNAKEM
Middle Name:ANNETTE
Last Name:KAZEEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 ORIZABA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804
Mailing Address - Country:US
Mailing Address - Phone:832-724-9815
Mailing Address - Fax:
Practice Address - Street 1:10919 LOUETTA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1710
Practice Address - Country:US
Practice Address - Phone:281-251-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily