Healthcare Provider Details

I. General information

NPI: 1518395458
Provider Name (Legal Business Name): CHIZOMAM OKORAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2013
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21630 MERCHANTS WAY
KATY TX
77449
US

IV. Provider business mailing address

10011 SHIRE GREEN LN
RICHMOND TX
77407-2615
US

V. Phone/Fax

Practice location:
  • Phone: 832-230-1518
  • Fax: 281-741-7355
Mailing address:
  • Phone: 713-303-8167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number112207
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: