Provider Demographics
NPI:1194955328
Name:ENNIN, KWAME APPIAGYEI (MD)
Entity type:Individual
Prefix:
First Name:KWAME
Middle Name:APPIAGYEI
Last Name:ENNIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 W PARKER RD STE 470
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8338
Mailing Address - Country:US
Mailing Address - Phone:972-608-8868
Mailing Address - Fax:972-608-0366
Practice Address - Street 1:6020 W PARKER RD STE 470
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8338
Practice Address - Country:US
Practice Address - Phone:972-608-8868
Practice Address - Fax:972-608-0366
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3712207X00000X, 207XS0114X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX415351YKP5Medicare PIN