Provider Demographics
NPI:1760175202
Name:TRI-CROWNS HOLISTIC HEALTHCARE PLLC
Entity Type:Organization
Organization Name:TRI-CROWNS HOLISTIC HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEMOLA
Authorized Official - Middle Name:ODUNAYO
Authorized Official - Last Name:ABIOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-337-1075
Mailing Address - Street 1:4840 RUBEN SOTO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-1253
Mailing Address - Country:US
Mailing Address - Phone:940-400-9066
Mailing Address - Fax:915-257-6295
Practice Address - Street 1:7362 REMCON CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1623
Practice Address - Country:US
Practice Address - Phone:940-400-9066
Practice Address - Fax:915-257-6295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty