Basic Information
| Provider Information | |||||||||
| NPI: | 1144667239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OKWARA | ||||||||
| FirstName: | CHINEMEREM | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 845347 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752847208 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1801 INWOOD RD FL 6 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752357202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146450575 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2013 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Q5885 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | MD2019-0171 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 390200000X | NM | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | BP10047489 | TX | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RG0100X | Q5885 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.