Healthcare Provider Details

I. General information

NPI: 1942645627
Provider Name (Legal Business Name): KATE AMAKA OKWESA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 CARVER DR
WYLIE TX
75098-8475
US

IV. Provider business mailing address

104 WHISPERING PINES AVE
FRIENDSWOOD TX
77546-4911
US

V. Phone/Fax

Practice location:
  • Phone: 214-592-5174
  • Fax:
Mailing address:
  • Phone: 281-941-5244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number766269
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1073709
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: