Basic Information
| Provider Information | |||||||||
| NPI: | 1336638709 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OKOROAFOR | ||||||||
| FirstName: | EMMANUEL | ||||||||
| MiddleName: | OKECHUKWU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5616 WORTHING PL | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760176576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177070093 | ||||||||
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| Practice Location | |||||||||
| Address1: | 710 W LEUDA ST | ||||||||
| Address2: | |||||||||
| City: | FT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761043114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177025958 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2018 | ||||||||
| LastUpdateDate: | 10/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP137339 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | AP137339 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.