MEDICARE: JOSHUA AMECHI OKONYE PT, DPT, CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40745	FL
2	225100000X	Physical Therapist	1381567	TX

General Provider Information

NPI Number	:	1578321030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA AMECHI OKONYE PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	2020 WESTCREEK LN APT 2312
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3643
Country	:	US
Telephone Number	:	832-518-0579
Fax Number	:

Provider Business Practice Location Address
First Line	:	3830 WILCREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-6718
Country	:	US
Telephone Number	:	832-518-0579
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	07/02/2024

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