Provider Demographics
NPI:1023219862
Name:AGYARKO, AFUA S (MD)
Entity type:Individual
Prefix:
First Name:AFUA
Middle Name:S
Last Name:AGYARKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 FM 2920 RD STE A2
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3111
Mailing Address - Country:US
Mailing Address - Phone:281-729-6481
Mailing Address - Fax:832-232-5591
Practice Address - Street 1:4701 FM 2920 RD STE A2
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3111
Practice Address - Country:US
Practice Address - Phone:281-729-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9779207RB0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209661203Medicaid
TX209661202Medicaid
TX286970Medicare PIN
TX286970YL0GMedicare PIN
TX209661202Medicaid