Provider Demographics
NPI:1124808589
Name:OKEKE, WESLEY OBIUKWU (PT)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:OBIUKWU
Last Name:OKEKE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18705
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-8705
Mailing Address - Country:US
Mailing Address - Phone:281-240-3140
Mailing Address - Fax:281-605-5075
Practice Address - Street 1:1449 HIGHWAY 6 STE 260
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5146
Practice Address - Country:US
Practice Address - Phone:281-240-3140
Practice Address - Fax:281-605-5075
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1381659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1381659OtherPHYSICAL THERAPY LICENSE