Provider Demographics
NPI:1326191081
Name:ASAMOAH, VIVIAN ABENAA (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:ABENAA
Last Name:ASAMOAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIVIAN
Other - Middle Name:ABENAA
Other - Last Name:ASAMOAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:25230 KINGSLAND BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2097
Mailing Address - Country:US
Mailing Address - Phone:281-746-9284
Mailing Address - Fax:
Practice Address - Street 1:25230 KINGSLAND BLVD STE 101
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2097
Practice Address - Country:US
Practice Address - Phone:281-746-9284
Practice Address - Fax:877-327-8082
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0163207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB136446Medicare PIN