Provider Demographics
NPI:1568973378
Name:OKORO, CHINONSO (DPT)
Entity type:Individual
Prefix:
First Name:CHINONSO
Middle Name:
Last Name:OKORO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:OKORO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:945 STOCKTON DR UNIT 4130
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6154
Mailing Address - Country:US
Mailing Address - Phone:214-281-8522
Mailing Address - Fax:469-608-8770
Practice Address - Street 1:945 STOCKTON DR UNIT 4130
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6154
Practice Address - Country:US
Practice Address - Phone:214-281-8522
Practice Address - Fax:469-608-8770
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003809225100000X
TX13252883225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist