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General NPI Number Information
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NPI Number | 1174187744
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Entity Type | Individual
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Provider Name | CHARLES EBERE OKPARA FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 12/19/2020
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Provider Practice Location Address
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Address Line | 6409 PRESTON RD
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City | DALLAS
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State | TX
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Zip | 75205-1610
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Country | US
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Telephone | 602-909-8026
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Fax |
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Provider Business Mailing Address
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Address Line | 8016 STONEHILL DR
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City | PLANO
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State | TX
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Zip | 75025-2564
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 778078
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License Number State | TX
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