Healthcare Provider Details

I. General information

NPI: 1477861037
Provider Name (Legal Business Name): MR. FIDELIS OKOYE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7457 HARWIN DR SUITE 213
HOUSTON TX
77036-2018
US

IV. Provider business mailing address

14930 SUGAR PEAK DR
SUGAR LAND TX
77498-5373
US

V. Phone/Fax

Practice location:
  • Phone: 281-888-5076
  • Fax:
Mailing address:
  • Phone: 713-894-4455
  • Fax: 713-456-3494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: