Healthcare Provider Details

I. General information

NPI: 1609771914
Provider Name (Legal Business Name): RENEWED LIFE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 PEGASUS DR
FORNEY TX
75126-1337
US

IV. Provider business mailing address

1620 PEGASUS DR
FORNEY TX
75126-1337
US

V. Phone/Fax

Practice location:
  • Phone: 469-269-9972
  • Fax:
Mailing address:
  • Phone: 469-269-9972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHINWENDU PEACE ONWUSOR
Title or Position: OWNER
Credential: PMHNP
Phone: 469-269-9972