Provider Demographics
NPI:1720647340
Name:OKUKPE, AUGUSTINE
Entity Type:Individual
Prefix:
First Name:AUGUSTINE
Middle Name:
Last Name:OKUKPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 SILVER LEAF DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-5027
Mailing Address - Country:US
Mailing Address - Phone:281-414-8799
Mailing Address - Fax:
Practice Address - Street 1:2118 SILVER LEAF DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5027
Practice Address - Country:US
Practice Address - Phone:281-414-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX685224163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse