Provider Demographics
NPI:1235210774
Name:NWOKEJI, CORDELL OKEZIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CORDELL
Middle Name:OKEZIE
Last Name:NWOKEJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:DEPT. 183
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:22751 PROFESSIONAL DR
Practice Address - Street 2:SUITE 270
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6021
Practice Address - Country:US
Practice Address - Phone:281-358-0171
Practice Address - Fax:281-358-2194
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1988208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185730201Medicaid
TXP01215715OtherRAILROAD MEDICARE
TX8BR410OtherBLUE CROSS BLUE SHIELD
TX185730204Medicaid
TX8F8707OtherMEDICARE
TX185730203Medicaid
TX281313YKYCMedicare PIN
TX8BR410OtherBLUE CROSS BLUE SHIELD
TX185730203Medicaid