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General NPI Number Information
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NPI Number | 1124922968
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Entity Type | Organization
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Legal Business Name | THRIVE ADDICTION & PSYCHIATRY CLINIC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 9861 SAGINAW BLVD STE 300
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City | FORT WORTH
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State | TX
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Zip | 76179-5196
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Country | US
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Telephone | 214-469-6280
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Fax |
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Provider Business Mailing Address
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Address Line | 9861 SAGINAW BLVD STE 300
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City | FORT WORTH
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State | TX
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Zip | 76179-5196
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TOCHUKWU UDEGBUNE
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Credential | DNP, PMHNP-BC
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Telephone | 214-469-6280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State | NULL
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