Provider Demographics
NPI:1962390559
Name:AKINNOLA, ZACHARIAH
Entity type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:
Last Name:AKINNOLA
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 1:7402 POTTERS TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-7778
Mailing Address - Country:US
Mailing Address - Phone:512-704-3119
Mailing Address - Fax:
Practice Address - Street 1:500 W WHITESTONE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2271
Practice Address - Country:US
Practice Address - Phone:512-918-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1406732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist