Healthcare Provider Details

I. General information

NPI: 1972169753
Provider Name (Legal Business Name): DANIEL OKOYE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 WURZBACH RD STE 700
SAN ANTONIO TX
78240-4332
US

IV. Provider business mailing address

3935 THOUSAND OAKS DR APT 606
SAN ANTONIO TX
78217-1869
US

V. Phone/Fax

Practice location:
  • Phone: 210-737-8090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number323548
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: