Eziaha Victor Ihediwah

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1104379 Issued in TX

Practice address

6060 N Central Expy Ste 500
Dallas, TX 75206-5249

Phone

(945) 296-2799

NPI assigned

Jan 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, MD, AZ, WA, DC, NM, CA7 enrollments

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 7

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Solidbase Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Forney, TX
  • NPI 1275311888
  Medicare reassignment Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, DC, NM, Psychiatric/Mental Health, TX, WA

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  TX

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  Psychiatric/Mental Health, TX

  Medicare reassignment NPD
• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713

  TX

  Medicare reassignment

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1447965660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 SHACKELFORD LN",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751265096",
            "telephone_number": "929-222-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 N CENTRAL EXPY STE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752065249",
            "telephone_number": "945-296-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHEDIWAH",
        "first_name": "EZIAHA",
        "middle_name": "VICTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1104379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iheart Amb-Surg DMC LLC
• Iheart Cardiac & Vascular Imaging I, LLC
• Iheart Care DMC, LLC
• Iheart Care Practice TX99, PLLC
• Iheart CVM I, LLC
• Olivia Chidimma Iheme
• IHS Chiropractic & Acupuncture Inc
• IHS-Iom Ventures
• Chinyere A Ihunnah, MSN, APRN, AGACNP-BC
• Nkechi Ikediobi, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.