Individual provider Active NPI

Eucharia Okolo, PA-C

  • Surgical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1073930558
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA09018 Issued in TX
Practice address
1325 Pennsylvania Ave Ste 890
Fort Worth, TX 76104-2145
Phone
(817) 250-4280
Fax
(817) 250-4281
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09018 TX
Surgical Physician Assistant 363AS0400X PA09018 TX Primary

Addresses

Primary practice location

1325 Pennsylvania Ave Ste 890
Fort Worth, TX 76104-2145

Mailing address

752 N Main St Unit 304
Mansfield, TX 76063-3248

Other names 1

  • Eucharia Okolo Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150414001794 TX Practitioner - Physician Assistant 4082932421 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09018TXMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1073930558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 N MAIN ST UNIT 304",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 890",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042145",
            "telephone_number": "817-250-4280",
            "fax_number": "817-250-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOLO",
        "first_name": "EUCHARIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09018",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA09018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUCHARIA",
            "last_name": "OKOLO",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.