=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467480806
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOUIS C OKAFOR SR
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/28/2006
-----------------------------------------------------
Last Update Date | 09/30/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9224 MARKVILLE DR
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75243-4404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-222-2960
-----------------------------------------------------
Fax | 972-792-7014
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9224 MARKVILLE DR
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75243-4404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-222-2960
-----------------------------------------------------
Fax | 972-792-7014
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ CEO
-----------------------------------------------------
Name | MR. LOUIS CHINEDU OKAFOR SR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-228-9276
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0066619
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------