MEDICARE: OPTIMUM PSYCHIATRIC CARE AND WELLNESS 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	:	1942149018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM PSYCHIATRIC CARE AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	5996 OJO DE AGUA DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-7540
Country	:	US
Telephone Number	:	915-666-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 N COTTON ST STE 1H
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3015
Country	:	US
Telephone Number	:	915-282-8344
Fax Number	:

Authorized Official
Title or Position	:	OWNER OF ENTITY
Name	:	AFOMA NWANKWO
Credential	:
Telephone Number	:	915-666-0800

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	04/07/2026

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