=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861685000
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OPARA PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2007
-----------------------------------------------------
Last Update Date | 07/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 224 S BLISS AVE
-----------------------------------------------------
City | DUMAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79029-3806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-935-4686
-----------------------------------------------------
Fax | 806-935-4725
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 224 S BLISS AVE
-----------------------------------------------------
City | DUMAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79029-3806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-935-4686
-----------------------------------------------------
Fax | 806-935-4725
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. OSITADINMA O OPARA
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 806-935-4686
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------