Healthcare Provider Details

I. General information

NPI: 1285495317
Provider Name (Legal Business Name): 24-7 SHALOM PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 TURTLE CREEK BLVD STE 300
DALLAS TX
75219-6243
US

IV. Provider business mailing address

2911 TURTLE CREEK BLVD STE 300
DALLAS TX
75219-6243
US

V. Phone/Fax

Practice location:
  • Phone: 214-866-9270
  • Fax: 972-803-3431
Mailing address:
  • Phone: 214-518-2035
  • Fax: 972-803-3431

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: PEACE ISHMAEL BOSIRE OKIENYA
Title or Position: OWNER/CEO
Credential: PMHNP
Phone: 214-866-9270