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EMMANUEL EDMUND SACKEY MD NPI 1417060724


NPI Information

NPI: 1417060724
Provider Name: EMMANUEL EDMUND SACKEY, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 45D0945655

Address:
601 S CLAY ST STE 101
ENNIS, TX
ZIP 75119
Phone: (972) 875-5220
Get Directions

Emmanuel Edmund Sackey, MD is a pediatrics in Ennis, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Emmanuel Edmund Sackey, MD NPI is 1417060724. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 S CLAY ST STE 101
ENNIS, TX
ZIP 75119-771
Phone: (972) 875-5220
Fax: (972) 875-5606

The CLIA number assigned to this NPI record is 45D0945655 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsK4222TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F95631MEDICARE UPINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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