Healthcare Provider Details

I. General information

NPI: 1124645973
Provider Name (Legal Business Name): STEPHEN OKWOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2020
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 AUSTIN ST STE B
HEMPSTEAD TX
77445-4650
US

IV. Provider business mailing address

PO BOX 554
HEMPSTEAD TX
77445-0554
US

V. Phone/Fax

Practice location:
  • Phone: 857-312-0725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56624
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: