Healthcare Provider Details

I. General information

NPI: 1306702089
Provider Name (Legal Business Name): EDWARD OCHUWA DBH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 WINDSOR KNOLL DR
DACULA GA
30019-7949
US

IV. Provider business mailing address

2710 WINDSOR KNOLL DR
DACULA GA
30019-7949
US

V. Phone/Fax

Practice location:
  • Phone: 713-927-5687
  • Fax:
Mailing address:
  • Phone: 713-927-5687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP297391
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: