Healthcare Provider Details

I. General information

NPI: 1194135574
Provider Name (Legal Business Name): JOY OKWUWA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 W GOLF COURSE RD STE 100
MIDLAND TX
79703-5110
US

IV. Provider business mailing address

3302 W GOLF COURSE RD STE 100
MIDLAND TX
79703-5110
US

V. Phone/Fax

Practice location:
  • Phone: 432-522-2304
  • Fax: 432-522-2307
Mailing address:
  • Phone: 432-522-2304
  • Fax: 432-522-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberR8181
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: