NPIMap

Organization Active NPI

Holistic Health and Psychiatry

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1649870783
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HOLISTIC HEALTH AND PSYCHIATRY
Practice address
4601 Hollow Tree Dr Ste 111
Arlington, TX 76018-1288
Phone
(817) 546-8000
Fax
(817) 345-0465
NPI assigned
Oct 28, 2020
Last updated
Dec 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Authorized official

Name
Peter Formusoh, APRNNPI 1114559325
Title
Owner of Entity
Phone
(817) 546-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

4601 Hollow Tree Dr Ste 111
Arlington, TX 76018-1288

Mailing address

4601 Hollow Tree Dr Ste 111
Arlington, TX 76018-1288
Phone (817) 546-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201103002327 TX Part B Supplier - Clinic/Group Practice 5890105829 Receives reassigned benefits from 9 practitioners
Practice locations: Arlington, TX

National Provider Directory

National Provider Directory

Locations

4601 Hollow Tree Dr
Ste 111
Arlington, TX 76018
Phone (817) 546-8000

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765497600000",
    "number": "1649870783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 HOLLOW TREE DR STE 111",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181288",
            "telephone_number": "817-546-8000",
            "fax_number": "817-345-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 HOLLOW TREE DR STE 111",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181288",
            "telephone_number": "817-546-8000",
            "fax_number": "817-345-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HEALTH AND PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A",
        "authorized_official_last_name": "FORMUSOH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "817-546-8000",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.