Provider Demographics
NPI:1417706631
Name:IGBOKWE, PATRICK IYKE (APRN)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:IYKE
Last Name:IGBOKWE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14605 PRAIRIE FIRE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-7028
Mailing Address - Country:US
Mailing Address - Phone:214-469-4213
Mailing Address - Fax:
Practice Address - Street 1:2920 LEE ST # 203
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-4111
Practice Address - Country:US
Practice Address - Phone:214-469-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158719363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health