Provider Demographics
NPI:1710296736
Name:CECILIA OKAFOR DO PA
Entity Type:Organization
Organization Name:CECILIA OKAFOR DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:NNENNA
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-398-0398
Mailing Address - Street 1:1143 S BUCKNER BLVD STE 144
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-4304
Mailing Address - Country:US
Mailing Address - Phone:214-398-0398
Mailing Address - Fax:214-398-7200
Practice Address - Street 1:204 LAURA LN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-2803
Practice Address - Country:US
Practice Address - Phone:214-325-2002
Practice Address - Fax:972-642-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center