Healthcare Provider Details

I. General information

NPI: 1053241281
Provider Name (Legal Business Name): ELEVATED HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 STATE HIGHWAY 26 STE 200
GRAPEVINE TX
76051-2245
US

IV. Provider business mailing address

1785 STATE HIGHWAY 26 STE 200
GRAPEVINE TX
76051-2245
US

V. Phone/Fax

Practice location:
  • Phone: 469-355-4557
  • Fax: 469-355-4557
Mailing address:
  • Phone: 469-355-4557
  • Fax: 469-355-4557

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: OLUCHI IJEOMA UWAJUMOGU
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 469-355-4557