Provider Demographics
NPI:1619481835
Name:TAKWI OMENE, ZIAN IJANG (PMHNP- BC, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:ZIAN
Middle Name:IJANG
Last Name:TAKWI OMENE
Suffix:
Gender:F
Credentials:PMHNP- BC, FNP-C
Other - Prefix:DR
Other - First Name:ZIAN
Other - Middle Name:IJANG
Other - Last Name:TAKWI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 W MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4611
Mailing Address - Country:US
Mailing Address - Phone:817-759-7000
Mailing Address - Fax:817-759-7027
Practice Address - Street 1:13749 GREEN ELM RD
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008
Practice Address - Country:US
Practice Address - Phone:713-391-9343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135883363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily