Provider Demographics
NPI:1841676483
Name:KWAPONG-AYEH, AGNES (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:KWAPONG-AYEH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8323 SOUTHWEST FWY STE 270
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1618
Mailing Address - Country:US
Mailing Address - Phone:832-274-5991
Mailing Address - Fax:
Practice Address - Street 1:8323 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1615
Practice Address - Country:US
Practice Address - Phone:832-274-5991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128716363LA2200X
MDACOO4569363LP0808X
TX758205363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health