Healthcare Provider Details

I. General information

NPI: 1760344766
Provider Name (Legal Business Name): BLESSED CHINEMEREM OKOH PMHNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2025
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 JOE RAMSEY BLVD E BLDG 4
GREENVILLE TX
75401-7727
US

IV. Provider business mailing address

14812 BELL MANOR CT
BALCH SPRINGS TX
75180-4326
US

V. Phone/Fax

Practice location:
  • Phone: 469-961-4857
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP70071824
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: