Provider Demographics
NPI:1962714048
Name:OKG INC
Entity type:Organization
Organization Name:OKG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:EKUKPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-331-0566
Mailing Address - Street 1:4720 LYNNACRE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-7911
Mailing Address - Country:US
Mailing Address - Phone:214-331-0566
Mailing Address - Fax:214-331-1997
Practice Address - Street 1:4720 LYNNACRE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-7911
Practice Address - Country:US
Practice Address - Phone:214-331-0566
Practice Address - Fax:214-331-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130012261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care