Provider Demographics
NPI:1235806498
Name:AKYEA, SHEM K
Entity Type:Individual
Prefix:
First Name:SHEM
Middle Name:K
Last Name:AKYEA
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 1:6201 S CAGE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5612
Mailing Address - Country:US
Mailing Address - Phone:956-702-5050
Mailing Address - Fax:
Practice Address - Street 1:6201 S CAGE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5612
Practice Address - Country:US
Practice Address - Phone:956-702-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist