Provider Demographics
NPI:1477016228
Name:OKOYE, MIRIAN CHIBUZO (MD)
Entity Type:Individual
Prefix:
First Name:MIRIAN
Middle Name:CHIBUZO
Last Name:OKOYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 GEORGE BUSH HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4277
Mailing Address - Country:US
Mailing Address - Phone:972-792-7300
Mailing Address - Fax:
Practice Address - Street 1:2821 GEORGE BUSH HWY STE 300
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4277
Practice Address - Country:US
Practice Address - Phone:972-792-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU4888207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine