Provider Demographics
NPI:1922663830
Name:AKANNI, THOMAS (NP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:AKANNI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 STERLING MANOR LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4696
Mailing Address - Country:US
Mailing Address - Phone:713-248-4090
Mailing Address - Fax:
Practice Address - Street 1:5310 STERLING MANOR LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4696
Practice Address - Country:US
Practice Address - Phone:713-248-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily