Provider Demographics
NPI:1487133112
Name:WADE, AKILAH (APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:AKILAH
Middle Name:
Last Name:WADE
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14018 LONG MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-4657
Mailing Address - Country:US
Mailing Address - Phone:832-622-1970
Mailing Address - Fax:
Practice Address - Street 1:1919 S BRAESWOOD BLVD STE 5330
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4466
Practice Address - Country:US
Practice Address - Phone:832-827-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAPP133278363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care