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General NPI Number Information
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NPI Number | 1164372066
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Entity Type | Organization
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Legal Business Name | ELPIS PSYCHIATRY LLC.
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 5203 JUAN TABO BLVD NE STE 2B
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2691
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Country | US
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Telephone | 719-678-7970
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Fax |
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Provider Business Mailing Address
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Address Line | 5203 JUAN TABO BLVD NE STE 2B
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2691
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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 | NP
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Name | THOMAS I ODUAH
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Credential | DNP
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Telephone | 719-678-7970
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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 |
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