MEDICARE: GRACEBRIDGE PSYCHIATRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1225963820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEBRIDGE PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	7616 BRANFORD PL STE 220
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3794
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7616 BRANFORD PL STE 220
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3794
Country	:	US
Telephone Number	:	405-430-3622
Fax Number	:

Authorized Official
Title or Position	:	PMHNP-BC
Name	:	TOCHI NKWOCHA
Credential	:
Telephone Number	:	405-430-3622

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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