Individual
AKENJEM EBONG MBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1902 COUNTRY CLUB DR STE 160, CARROLLTON, TX 75006-5823
(214) 606-2448
Mailing address
2411 ASKEW DR, ANNA, TX 75409-0179
(404) 325-8552
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AP135083
TX
363LF0000X
Family Nurse Practitioner
Primary
AP135083
TX
Other
Enumeration date
10/05/2017
Last updated
10/12/2017
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