Provider Demographics
NPI:1073052866
Name:EFFIOK EKPENYONG, M.D. PLLC
Entity Type:Organization
Organization Name:EFFIOK EKPENYONG, M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EFFIOK
Authorized Official - Middle Name:S
Authorized Official - Last Name:EKPENYONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-282-5055
Mailing Address - Street 1:2408 PERDENALES DR
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-5075
Mailing Address - Country:US
Mailing Address - Phone:214-282-5055
Mailing Address - Fax:972-248-3198
Practice Address - Street 1:2408 PERDENALES DR
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-5075
Practice Address - Country:US
Practice Address - Phone:214-282-5055
Practice Address - Fax:972-248-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty