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General NPI Number Information
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NPI Number | 1497830798
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Entity Type | Individual
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Provider Name | GODWIN E OKOJIE PA
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 4801 BRYAN ST SUITE 500
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City | DALLAS
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State | TX
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Zip | 75204-8300
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Country | US
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Telephone | 214-515-9646
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 ROSS AVE SUITE 500
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City | DALLAS
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State | TX
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Zip | 75204-5138
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Country | US
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Telephone | 214-515-9646
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 011499
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 18648
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA05751
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License Number State | TX
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