Provider Demographics
NPI:1972035277
Name:OKOLI, NKECHI
Entity Type:Individual
Prefix:MRS
First Name:NKECHI
Middle Name:
Last Name:OKOLI
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 1:506 BERWICK TOWN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2080
Mailing Address - Country:US
Mailing Address - Phone:210-288-5520
Mailing Address - Fax:
Practice Address - Street 1:506 BERWICK TOWN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2080
Practice Address - Country:US
Practice Address - Phone:210-288-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist