Individual provider Active NPI

Henrietta A Aguwa, FNP

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1063256741
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1169291 Issued in TX
Practice address
2356 Calendar CT
Grand Prairie, TX 75050-7626
Phone
(817) 564-4971
Fax
(281) 729-8173
NPI assigned
Jun 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 905033 TX
Nurse Practitioner 363L00000X 1169291 TX
Family Nurse Practitioner 363LF0000X 1169291 TX Primary

Addresses

Primary practice location

2356 Calendar CT
Grand Prairie, TX 75050-7626

Mailing address

2356 Calendar CT
Grand Prairie, TX 75050-7626
Phone (817) 564-4971

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
I20250404002875 TX Practitioner - Nurse Practitioner 0749704310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PS Health Services LLCGroup PAC ID 7214311844, 6 clinicians

Practice addresses (Care Compare)

3008 Peppercorn Dr
Euless, TX 76039-4140
Phone (817) 527-1182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
905033TXMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
PS Health Services LLC CurrentSince Nov 26, 2025 Accepting new patients
Alpha and Omega Star LLC Family CurrentSince Dec 1, 2025 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1063256741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 CALENDAR CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750507626",
            "telephone_number": "817-564-4971",
            "fax_number": "281-729-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 CALENDAR CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750507626",
            "telephone_number": "817-564-4971",
            "fax_number": "281-729-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUWA",
        "first_name": "HENRIETTA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "905033",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1169291",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1169291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.