Healthcare Provider Details

I. General information

NPI: 1730040429
Provider Name (Legal Business Name): DORIS CHIKAODIRI OKONKWO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 N BELT LINE RD APT 3092
IRVING TX
75062-7814
US

IV. Provider business mailing address

3454 N BELT LINE RD APT 3092
IRVING TX
75062-7814
US

V. Phone/Fax

Practice location:
  • Phone: 254-987-1609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberACOO8354
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: