Provider Demographics
NPI:1902594716
Name:EMPOWERING CONQUERORS PSYCHIATRY, LLC
Entity type:Organization
Organization Name:EMPOWERING CONQUERORS PSYCHIATRY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN
Authorized Official - Phone:713-240-2193
Mailing Address - Street 1:3707 CYPRESS CREEK PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3584
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3707 CYPRESS CREEK PKWY STE 310
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3584
Practice Address - Country:US
Practice Address - Phone:713-240-2193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPOWERING CONQUERORS PSYCHIATRY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-28
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty