Provider Demographics
NPI:1104915396
Name:OKEKE, JOSEPH OKONKWO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:OKONKWO
Last Name:OKEKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:OKONKWO
Other - Last Name:OKEKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7714 SHELBURNE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4684
Mailing Address - Country:US
Mailing Address - Phone:832-794-8826
Mailing Address - Fax:832-794-8826
Practice Address - Street 1:7714 SHELBURNE CIR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4684
Practice Address - Country:US
Practice Address - Phone:832-794-8826
Practice Address - Fax:832-794-8826
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1175208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHA17Medicare ID - Type Unspecified