Provider Demographics
NPI:1942781257
Name:AKINADE, AMAKA J (NP)
Entity Type:Individual
Prefix:
First Name:AMAKA
Middle Name:J
Last Name:AKINADE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMAKA
Other - Middle Name:J
Other - Last Name:ONWUKWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:560 MEYERLAND PLAZA MALL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1615
Practice Address - Country:US
Practice Address - Phone:713-442-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX729994363L00000X
TXAP138203363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX396160901Medicaid