Provider Demographics
NPI:1316245558
Name:NGYIA, ELVIS (PHD, NP-C, PMHNP-C)
Entity type:Individual
Prefix:
First Name:ELVIS
Middle Name:
Last Name:NGYIA
Suffix:
Gender:M
Credentials:PHD, NP-C, PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 W PIONEER PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4726
Mailing Address - Country:US
Mailing Address - Phone:972-790-1200
Mailing Address - Fax:972-646-8085
Practice Address - Street 1:929 W PIONEER PKWY STE A
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4726
Practice Address - Country:US
Practice Address - Phone:972-790-1200
Practice Address - Fax:972-646-8085
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-12
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX796648163W00000X
TXAP120017363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily