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General NPI Number Information
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NPI Number | 1366244311
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Entity Type | Organization
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Legal Business Name | ELEVATE LIFE PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 675 TOWN SQUARE BLVD
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City | GARLAND
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State | TX
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Zip | 75040-2992
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Country | US
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Telephone | 972-525-0251
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Fax | 972-755-6623
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Provider Business Mailing Address
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Address Line | 750 E US HIGHWAY 80 STE 200
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City | FORNEY
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State | TX
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Zip | 75126-8728
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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 & CEO
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Name | DAVID OSUJI
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Credential |
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Telephone | 469-556-8413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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