Provider Demographics
NPI:1821104431
Name:OKANI, OFOBUIKE (MD)
Entity Type:Individual
Prefix:
First Name:OFOBUIKE
Middle Name:
Last Name:OKANI
Suffix:
Gender:M
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:6520 HORIZON CIR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6985
Practice Address - Country:US
Practice Address - Phone:254-755-4460
Practice Address - Fax:254-755-4469
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7614207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137651911Medicaid
TX137651903Medicaid
TXP00930578OtherRAILROAD MEDICARE
TX83G504Medicare ID - Type Unspecified
TXTXB127629Medicare PIN