Healthcare Provider Details

I. General information

NPI: 1164372066
Provider Name (Legal Business Name): ELPIS PSYCHIATRY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5203 JUAN TABO BLVD NE STE 2B
ALBUQUERQUE NM
87111-2691
US

IV. Provider business mailing address

5203 JUAN TABO BLVD NE STE 2B
ALBUQUERQUE NM
87111-2691
US

V. Phone/Fax

Practice location:
  • Phone: 719-678-7970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: THOMAS I ODUAH
Title or Position: NP
Credential: DNP
Phone: 719-678-7970