Provider Demographics
NPI:1073877700
Name:OKORO, OLUBUKOLA ADUKE (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUBUKOLA
Middle Name:ADUKE
Last Name:OKORO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:997 RAINTREE CIR STE 130
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4953
Mailing Address - Country:US
Mailing Address - Phone:972-390-7667
Mailing Address - Fax:972-390-1557
Practice Address - Street 1:997 RAINTREE CIR STE 130
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4953
Practice Address - Country:US
Practice Address - Phone:763-443-3926
Practice Address - Fax:972-390-1050
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301101483207R00000X
TXQ6407207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine