Provider Demographics
NPI:1023693512
Name:ACHUSI, OKWI AFAM
Entity type:Individual
Prefix:MR
First Name:OKWI
Middle Name:AFAM
Last Name:ACHUSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 N STATE HIGHWAY 360 APT 8301
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-9038
Mailing Address - Country:US
Mailing Address - Phone:817-933-2781
Mailing Address - Fax:
Practice Address - Street 1:370 N STATE HIGHWAY 360 APT 8301
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9038
Practice Address - Country:US
Practice Address - Phone:817-933-2781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230201164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse