Provider Demographics
NPI:1144226515
Name:ANKOMA-SEY, VICTOR (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ANKOMA-SEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 300928
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-0928
Mailing Address - Country:US
Mailing Address - Phone:713-799-8300
Mailing Address - Fax:713-799-8305
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:STE 225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3002
Practice Address - Country:US
Practice Address - Phone:713-799-8300
Practice Address - Fax:713-799-8305
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
TXK1344173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A4989Medicare ID - Type Unspecified
TX00896QMedicare ID - Type Unspecified
TXF42362Medicare UPIN