Provider Demographics
NPI:1053911404
Name:OKOYE, AUSTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:OKOYE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 NADAR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-6791
Mailing Address - Country:US
Mailing Address - Phone:682-222-7494
Mailing Address - Fax:
Practice Address - Street 1:1521 N COCKRELL HILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1315
Practice Address - Country:US
Practice Address - Phone:214-337-8092
Practice Address - Fax:214-337-8359
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist