Provider Demographics
NPI:1710249826
Name:AYUK-TAKEM, SHIRLEY OROCK (DO)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:OROCK
Last Name:AYUK-TAKEM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18618 SOUTHARD OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:215-833-9637
Mailing Address - Fax:
Practice Address - Street 1:18618 SOUTHARD OAKS DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7769
Practice Address - Country:US
Practice Address - Phone:281-671-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020092207R00000X
NJ25MB09707700207RC0200X
PAOS0184466207RC0200X
NMA-2143-18207RC0200X
TXR4663207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine