Most Relevant Information
Provider Data
| NPI Number: | 1003662917 |
| Provider Name: | KELLY OKPAGU MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | BP10088602 |
Most Important Dates
| Enumeration Date: | 04/30/2024 |
| Last Updated: | 04/30/2024 |
Provider Practice Location
700 E MARSHALL AVE
LONGVIEW
TX
756015580
Practice Location Phone/Fax
| Phone: | 9033152000 |
| Fax: |
Provider Mailing Location
1516 SNOW TRL
LEWISVILLE
TX
750777543
Provider Mailing Phone/Fax
| Phone: | 6822736510 |
| Fax: |