Healthcare Provider Details

I. General information

NPI: 1467746594
Provider Name (Legal Business Name): EKENE IFEYINWA OKOYE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 FANNIN ST MGJ9-002
HOUSTON TX
77030-2703
US

IV. Provider business mailing address

PO BOX 4701
HOUSTON TX
77210-4701
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-1577
  • Fax:
Mailing address:
  • Phone: 800-288-8325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberBP30040618
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberP5697
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: