Healthcare Provider Details

I. General information

NPI: 1902600299
Provider Name (Legal Business Name): HEPHZIBAH MENTAL HEALTH AND PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6402 PLEASANTON PKWY
PFLUGERVILLE TX
78660-6890
US

IV. Provider business mailing address

6402 PLEASANTON PKWY
PFLUGERVILLE TX
78660-6890
US

V. Phone/Fax

Practice location:
  • Phone: 903-394-9677
  • Fax:
Mailing address:
  • Phone: 903-394-9677
  • Fax: 833-605-4028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: FIYINFOLUWA OSENI
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 903-394-9677