Provider Demographics
NPI:1871953943
Name:OKAFOR, GENEVIEVE (MD)
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:OKAFOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-2129
Mailing Address - Country:US
Mailing Address - Phone:432-640-2408
Mailing Address - Fax:
Practice Address - Street 1:8050 E HIGHWAY 191 STE 104
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8614
Practice Address - Country:US
Practice Address - Phone:432-640-6476
Practice Address - Fax:432-640-4758
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT8904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program