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General NPI Number Information
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NPI Number | 1649870783
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Entity Type | Organization
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Legal Business Name | HOLISTIC HEALTH AND PSYCHIATRY
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 4601 HOLLOW TREE DR STE 111
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City | ARLINGTON
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State | TX
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Zip | 76018-1288
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Country | US
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Telephone | 817-546-8000
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Fax | 817-345-0465
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Provider Business Mailing Address
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Address Line | 4601 HOLLOW TREE DR STE 111
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City | ARLINGTON
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State | TX
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Zip | 76018-1288
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Country | US
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Telephone | 817-546-8000
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Fax | 817-345-0465
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | PETER FORMUSOH
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Credential | APRN
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Telephone | 817-546-8000
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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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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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