Provider Demographics
NPI:1891577268
Name:PURE PSYCHIATRY AND WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:PURE PSYCHIATRY AND WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKWURAH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-468-0438
Mailing Address - Street 1:21320 PROVINCIAL BLVD STE 500-A
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7580
Mailing Address - Country:US
Mailing Address - Phone:832-468-0438
Mailing Address - Fax:
Practice Address - Street 1:21320 PROVINCIAL BLVD STE 500-A
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7580
Practice Address - Country:US
Practice Address - Phone:832-468-0438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty