Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | Q4885 | TX |
NPI | 1013301043 |
---|---|
Provider Name | Edesiri Akajagbor |
First Address | Webster, TX 77598-4233 |
Second Address | Webster, TX 77598-4233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2015 |
Last Update Date | 16/01/2019 |