Provider Demographics
NPI:1558409425
Name:OKPON, LUCY TOMMY
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:TOMMY
Last Name:OKPON
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 1:7822 QUAIL MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2336
Mailing Address - Country:US
Mailing Address - Phone:713-729-8091
Mailing Address - Fax:713-729-3498
Practice Address - Street 1:7822 QUAIL MEADOW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2336
Practice Address - Country:US
Practice Address - Phone:713-729-8091
Practice Address - Fax:713-729-3498
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0098543747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009854Medicaid