Provider Demographics
NPI:1639918733
Name:EMPOWERED PSYCHIATRY AND WELLNESS PLLC
Entity type:Organization
Organization Name:EMPOWERED PSYCHIATRY AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:OMOLOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOYEDE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:346-517-7874
Mailing Address - Street 1:24044 CINCO VILLAGE BOULEVARD #100 PMB 041524
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24044 CINCO VILLAGE CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8433
Practice Address - Country:US
Practice Address - Phone:346-517-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty