Provider Demographics
NPI:1386829828
Name:OKEY OKOLI, M.D., P.A.
Entity Type:Organization
Organization Name:OKEY OKOLI, M.D., P.A.
Other - Org Name:ADVANCED WOMEN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-333-8895
Mailing Address - Street 1:PO BOX 691546
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78269-1546
Mailing Address - Country:US
Mailing Address - Phone:210-333-8895
Mailing Address - Fax:210-599-3693
Practice Address - Street 1:14100 NACOGDOCHES RD
Practice Address - Street 2:STE 140
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1903
Practice Address - Country:US
Practice Address - Phone:210-333-8895
Practice Address - Fax:210-599-3693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1418207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163240801Medicaid
TX00548WMedicare PIN