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General NPI Number Information
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NPI Number | 1902156490
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Entity Type | Individual
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Provider Name | OKEY OKECHUKWU DDS
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Gender | Male
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 4403 SHERWOOD WAY
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City | SAN ANGELO
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State | TX
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Zip | 76901-5616
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Country | US
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Telephone | 325-340-1594
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Fax |
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Provider Business Mailing Address
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Address Line | 4297 N O CONNOR RD
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City | IRVING
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State | TX
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Zip | 75062-7671
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28425
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License Number State | TX
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