Healthcare Provider Details

I. General information

NPI: 1184484230
Provider Name (Legal Business Name): CHIAMAKA LAWRENCIA OKORIE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5909 HARRY HINES BLVD SUITE HA4.240
DALLAS TX
75390-9192
US

IV. Provider business mailing address

2275 HAWES AVE APT 408
DALLAS TX
75235-3828
US

V. Phone/Fax

Practice location:
  • Phone: 214-648-3392
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: