Provider Demographics
NPI:1285495317
Name:24-7 SHALOM PSYCHIATRY PLLC
Entity type:Organization
Organization Name:24-7 SHALOM PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PEACE
Authorized Official - Middle Name:ISHMAEL BOSIRE
Authorized Official - Last Name:OKIENYA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:214-866-9270
Mailing Address - Street 1:2911 TURTLE CREEK BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-6243
Mailing Address - Country:US
Mailing Address - Phone:214-518-2035
Mailing Address - Fax:972-803-3431
Practice Address - Street 1:2911 TURTLE CREEK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-6243
Practice Address - Country:US
Practice Address - Phone:214-866-9270
Practice Address - Fax:972-803-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty