Provider Demographics
NPI:1811643125
Name:OKOYE-DIKE, ELIZABETH IFECHUKWU
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:IFECHUKWU
Last Name:OKOYE-DIKE
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 1:8902 SPOON CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3897
Mailing Address - Country:US
Mailing Address - Phone:713-875-2100
Mailing Address - Fax:
Practice Address - Street 1:4606 FM 1960 RD W STE 575
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4600
Practice Address - Country:US
Practice Address - Phone:713-995-0675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX583836163WW0000X, 163WX1500X, 163WH0200X, 163WI0500X
TXAP146082363LF0000X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU4340381702Medicaid