Healthcare Provider Details

I. General information

NPI: 1841494028
Provider Name (Legal Business Name): JOY OBOKHARE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOY FALOLA

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 08/24/2020
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S SONCY RD STE 104
AMARILLO TX
79119-6405
US

IV. Provider business mailing address

PO BOX 3046
MALVERN PA
19355-0746
US

V. Phone/Fax

Practice location:
  • Phone: 806-398-3627
  • Fax: 806-351-7801
Mailing address:
  • Phone: 806-398-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberP1909
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: