MEDICARE: JAMES AMILA OCHUKA FNP

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	363LF0000X	Family Nurse Practitioner	708267	TX

General Provider Information

NPI Number	:	1578826343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES AMILA OCHUKA FNP

Provider Business Mailing Address
First Line	:	15800 DOOLEY RD
Second Line	:	#100
City	:	ADDISON
State	:	TX
Zip	:	75001-4284
Country	:	US
Telephone Number	:	972-239-3849
Fax Number	:	972-934-4969

Provider Business Practice Location Address
First Line	:	15800 DOOLEY RD
Second Line	:	#100
City	:	ADDISON
State	:	TX
Zip	:	75001-4284
Country	:	US
Telephone Number	:	972-239-3849
Fax Number	:	972-934-4969

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

Provider Enumeration Date	:	06/18/2012
Last Update Date	:	06/18/2012

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