# EDWARD TIMOTHY OKELLEY MD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PalliCare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407553936
- **Authorized official:** JONATHAN FLUHART (CEO)
- **Authorized official phone:** (972) 632-9642

## Contact information

- **Practice address:** 155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
- **Practice address phone:** (888) 725-5422
- **Practice address fax:** (903) 501-1100
- **Mailing address:** 5803 STONERIDGE DR, TEXARKANA, TX 75503-1461
- **Mailing address phone:** (972) 632-9642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LC0200X | Critical Care Medicine Nurse Practitioner | — | NULL | — |
| 363LC1500X | Community Health Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/15/2023
- **Last updated:** 09/30/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | EG0567 | RAILROAD MEDICARE | NY |