Provider Demographics
NPI:1346012036
Name:VIVIQUE PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:VIVIQUE PSYCHIATRY PLLC
Other - Org Name:VIVIQUE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:ELEGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-820-3543
Mailing Address - Street 1:16325 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1233
Mailing Address - Country:US
Mailing Address - Phone:210-975-7505
Mailing Address - Fax:361-288-3247
Practice Address - Street 1:16325 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1233
Practice Address - Country:US
Practice Address - Phone:210-975-7505
Practice Address - Fax:361-288-3247
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIVIQUE PSYCHIATRY PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty