Individual provider Active NPI

Vanessa Mukasolu Echetabu Gray, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1447895289
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP143630 Issued in TX
Practice address
1430 Empire Central Dr FL 1
Dallas, TX 75247-4032
Phone
(214) 645-8500
Fax
(214) 648-3775
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 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 AP143630 TX Primary

Addresses

Primary practice location

1430 Empire Central Dr FL 1
Dallas, TX 75247-4032

Mailing address

5353 Harry Hines Blvd # 9070
Dallas, TX 75390-9070
Phone (214) 645-8500

Other practice location 1

2025 Guadalupe St Ste 260
Austin, TX 78705-5642
Phone (864) 336-2731

Other practice location 2

5323 Harry Hines Blvd
Dallas, TX 75390-4032
Phone (469) 291-2000

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
I20200622000826 TX Practitioner - Nurse Practitioner 3072935097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6363 Forest Park Rd 7TH FL
749 Univ of TX SW Med Ctr Psych
Dallas, TX 75390-9087
Phone (214) 645-8500

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 18, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 18, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas PastSince Nov 1, 2019 Accepting new patients

Locations

1430 Empire Central Dr
Fl 1
Dallas, TX 75247
Phone (214) 645-8500

6363 Frst Park Rd 7th Fl
Ste 749
Dallas, TX 75390
Phone (214) 645-8500

5353 Harry Hines Blvd
#9070
Dallas, TX 75390

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: vechetabu110166@direct.swmed.us

Organizations & group practices 4

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1447895289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 HARRY HINES BLVD # 9070",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909070",
            "telephone_number": "214-645-8500",
            "fax_number": "214-648-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 EMPIRE CENTRAL DR FL 1",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474032",
            "telephone_number": "214-645-8500",
            "fax_number": "214-648-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 Guadalupe St Ste 260",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787055642",
            "country_code": "US",
            "telephone_number": "864-336-2731",
            "fax_number": "833-740-3387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753904032",
            "country_code": "US",
            "telephone_number": "469-291-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECHETABU GRAY",
        "first_name": "VANESSA",
        "middle_name": "MUKASOLU",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP143630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.