Healthcare Provider Details

I. General information

NPI: 1144922667
Provider Name (Legal Business Name): LILY ANKRAH OBIOHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E HIGHWAY 114 STE 350
TROPHY CLUB TX
76262-5309
US

IV. Provider business mailing address

2800 E HIGHWAY 114 STE 350
TROPHY CLUB TX
76262-5309
US

V. Phone/Fax

Practice location:
  • Phone: 214-814-1758
  • Fax:
Mailing address:
  • Phone: 214-814-1758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number1112856
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: