Healthcare Provider Details

I. General information

NPI: 1750002028
Provider Name (Legal Business Name): AELIA WAQIF PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 W HOUSE ST
ALVIN TX
77511-2817
US

IV. Provider business mailing address

110 S GORDON ST
ALVIN TX
77511-2333
US

V. Phone/Fax

Practice location:
  • Phone: 281-968-7568
  • Fax:
Mailing address:
  • Phone: 281-968-7568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number962178
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1195724
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: