Provider Demographics
NPI:1184264277
Name:OGALA, FAITH I (PMHNP)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:I
Last Name:OGALA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8035 E R L THORNTON FWY STE 334
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-7018
Mailing Address - Country:US
Mailing Address - Phone:888-550-4842
Mailing Address - Fax:888-550-3391
Practice Address - Street 1:8035 E R L THORNTON FWY # 334
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7018
Practice Address - Country:US
Practice Address - Phone:888-550-4842
Practice Address - Fax:888-550-3391
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402953163WP0807X
CA95017454163WP0807X
IL209021104163WP0807X
TXAP144232363LP0808X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Single Specialty