Provider Demographics
NPI:1326516857
Name:OKOROAFOR, OBIAGERI OBY
Entity Type:Individual
Prefix:
First Name:OBIAGERI
Middle Name:OBY
Last Name:OKOROAFOR
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 1:7518 CENTENARY DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-3068
Mailing Address - Country:US
Mailing Address - Phone:214-498-2431
Mailing Address - Fax:
Practice Address - Street 1:7518 CENTENARY DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-3068
Practice Address - Country:US
Practice Address - Phone:214-498-2431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX731606163W00000X
TXAP146003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse