Individual provider Active NPI

Gabriel Nkwanyuo, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Desoto, TX
National Provider Identifier
1013866029
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1230894 Issued in TX
Practice address
941 York Dr Ste 201
Desoto, TX 75115-2066
Phone
(682) 200-4272
Fax
(682) 719-4099
NPI assigned
Jan 23, 2026
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1230894 TX Primary

Addresses

Primary practice location

941 York Dr Ste 201
Desoto, TX 75115-2066

Mailing address

2507 Mustang CT
Cedar Hill, TX 75104-2415
Phone (682) 200-4272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260422001644 TX Practitioner - Nurse Practitioner 6406323963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2507 Mustang CT
Cedar Hill, TX 75104-2415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1230894TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Assumption Health & Wellness Center LLC Psychiatric/Mental Health CurrentSince Sep 17, 2023 Accepting new patients

Locations

941 York Dr
Ste 201
Desoto, TX 75115
Phone (682) 200-4272

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1013866029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 MUSTANG CT",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042415",
            "telephone_number": "682-200-4272",
            "fax_number": "682-719-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 YORK DR STE 201",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152066",
            "telephone_number": "682-200-4272",
            "fax_number": "682-719-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKWANYUO",
        "first_name": "GABRIEL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1230894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.