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General NPI Number Information
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NPI Number | 1831818970
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Entity Type | Individual
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Provider Name | UGOCHUKWU T OKONKWO PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 510 MED CT STE 210
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3484
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Country | US
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Telephone | 210-494-4290
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Fax | 210-494-4809
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Provider Business Mailing Address
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Address Line | 27595 INTERSTATE 10 W APT 332
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City | BOERNE
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State | TX
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Zip | 78006-6638
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Country | US
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Telephone | 480-434-9393
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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 | PA18793
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License Number State | TX
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