Healthcare Provider Details

I. General information

NPI: 1053229286
Provider Name (Legal Business Name): MINDFUSE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BALCONES DR STE 23023
AUSTIN TX
78731-4257
US

IV. Provider business mailing address

5900 BALCONES DR STE 23023
AUSTIN TX
78731-4257
US

V. Phone/Fax

Practice location:
  • Phone: 877-211-9212
  • Fax: 877-497-2909
Mailing address:
  • Phone: 877-211-9212
  • Fax: 877-497-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHINEMEREM YVONNE UGORJI
Title or Position: MEMBER
Credential: MD
Phone: 832-402-4093