Provider Demographics
NPI:1003047135
Name:OKOCHE, CRYSTAL
Entity Type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:
Last Name:OKOCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1756 BELT LINE RD APT 148
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-6822
Mailing Address - Country:US
Mailing Address - Phone:214-607-7030
Mailing Address - Fax:469-366-4580
Practice Address - Street 1:1756 BELT LINE RD APT 148
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-6822
Practice Address - Country:US
Practice Address - Phone:214-607-7030
Practice Address - Fax:469-366-4580
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health