Provider Demographics
NPI:1386673234
Name:AUGUSTINE OKOYE
Entity Type:Organization
Organization Name:AUGUSTINE OKOYE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:CHIKE
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-793-2377
Mailing Address - Street 1:613 W MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-1045
Mailing Address - Country:US
Mailing Address - Phone:817-793-2377
Mailing Address - Fax:817-784-9865
Practice Address - Street 1:613 W MAIN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-1045
Practice Address - Country:US
Practice Address - Phone:817-793-2377
Practice Address - Fax:817-784-9865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5721360001Medicare NSC