MEDICARE: LUCY TOMMY OKPON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	009854	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558409425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY TOMMY OKPON

Provider Business Mailing Address
First Line	:	7822 QUAIL MEADOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2336
Country	:	US
Telephone Number	:	713-729-8091
Fax Number	:	713-729-3498

Provider Business Practice Location Address
First Line	:	7822 QUAIL MEADOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2336
Country	:	US
Telephone Number	:	713-729-8091
Fax Number	:	713-729-3498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/09/2007

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Directions to “ LUCY TOMMY OKPON ” Practice Location

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