Provider Demographics
NPI:1164293643
Name:WAKAPA, JOSEPH LEMAYAN
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEMAYAN
Last Name:WAKAPA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266-1620
Mailing Address - Country:US
Mailing Address - Phone:603-557-2946
Mailing Address - Fax:
Practice Address - Street 1:112 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-1620
Practice Address - Country:US
Practice Address - Phone:603-557-2946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health