Healthcare Provider Details

I. General information

NPI: 1770615460
Provider Name (Legal Business Name): ZEE OKUNNA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 E GRAUWYLER RD
IRVING TX
75061
US

IV. Provider business mailing address

1405 E GRAUWYLER RD
IRVING TX
75061
US

V. Phone/Fax

Practice location:
  • Phone: 972-438-7035
  • Fax: 972-438-5319
Mailing address:
  • Phone: 972-438-7035
  • Fax: 972-438-5319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9528
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: