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General NPI Number Information
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NPI Number | 1649853359
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Entity Type | Individual
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Provider Name | EMMANUEL OKON CNP, APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 3025 E RENNER RD STE 120
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City | RICHARDSON
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State | TX
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Zip | 75082-3581
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Country | US
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Telephone | 713-457-4372
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Fax | 713-457-0945
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Provider Business Mailing Address
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Address Line | 2553 PETTUS DR
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City | FORNEY
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State | TX
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Zip | 75126-4172
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Country | US
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Telephone | 469-569-5148
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1034096
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License Number State | TX
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