Individual
AKHILA VIJAYAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2060 SPACE PARK DR, SUITE 104, HOUSTON, TX 77058-3600
(832) 783-1999
Mailing address
2060 SPACE PARK DR, SUITE 104, HOUSTON, TX 77058-3600
(832) 783-1999
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
Q3986
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350827701
—
TX
05
—
350827702
—
TX
01
—
8FF463
BLUE CROSS BLUE SHIELD
TX
01
—
8GD946
BCBS
TX
Enumeration date
09/30/2008
Last updated
10/20/2017
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