MEDICARE: HID GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1750244190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HID GROUP INC

Provider Business Mailing Address
First Line	:	16057 SHERMAN WAY # 273
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-4023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16057 SHERMAN WAY # 273
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-4023
Country	:	US
Telephone Number	:	903-617-5098
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROSE ONYEKWE
Credential	:	NP
Telephone Number	:	903-617-7777

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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