Healthcare Provider Details

I. General information

NPI: 1356971196
Provider Name (Legal Business Name): PHILIPPA IFEOMA OKUMBOR APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3247 DAWES DR
DALLAS TX
75211-5760
US

IV. Provider business mailing address

18 KESTREL CT
HEATH TX
75032-2043
US

V. Phone/Fax

Practice location:
  • Phone: 214-330-7767
  • Fax: 214-330-7780
Mailing address:
  • Phone: 214-675-4732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP144674
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: