Provider Demographics
NPI:1972352003
Name:QUADRI, AKOREDE ABRAHAM
Entity type:Individual
Prefix:
First Name:AKOREDE
Middle Name:ABRAHAM
Last Name:QUADRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 PITCH PINE ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:75065-7607
Mailing Address - Country:US
Mailing Address - Phone:682-564-2668
Mailing Address - Fax:
Practice Address - Street 1:1002 PITCH PINE ST
Practice Address - Street 2:
Practice Address - City:HICKORY CREEK
Practice Address - State:TX
Practice Address - Zip Code:75065-7607
Practice Address - Country:US
Practice Address - Phone:682-564-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility