Individual
DR. PHYLLIS CHIZOMAM OKEREKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
110 UPTOWN AVENUE, SUITE A, BROWNSVILLE, TX 78520-7563
(956) 550-0200
(956) 550-0215
Mailing address
PO BOX 3067, BROWNSVILLE, TX 78523-3067
(956) 550-0200
(956) 550-0215
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
K9375
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094EQ
BLUE CROSS BLUE SHEILD
TX
05
—
0306821-01
—
TX
01
—
1760633326-2000
TEXAS DIABETIC COUNSEL
TX
Enumeration date
12/05/2005
Last updated
10/15/2009
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