Healthcare Provider Details

I. General information

NPI: 1003535881
Provider Name (Legal Business Name): OKONS&O MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 03/17/2024
Certification Date: 03/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17070 RED OAK DR STE 403
HOUSTON TX
77090-2609
US

IV. Provider business mailing address

17070 RED OAK DR STE 403
HOUSTON TX
77090-2609
US

V. Phone/Fax

Practice location:
  • Phone: 281-836-5691
  • Fax: 281-836-5692
Mailing address:
  • Phone: 773-600-4675
  • Fax: 281-836-5692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NZUBE OKONKWO
Title or Position: OWNER
Credential: MD
Phone: 773-600-4675