Individual provider Active NPI

Clifford Echabu

  • Psychiatric/Mental Health Nurse Practitioner
  • Garland, TX
National Provider Identifier
1659254001
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1207453 Issued in TX
Practice address
2910 Broadway Blvd Ste 102
Garland, TX 75041-3796
Phone
(240) 547-8312
NPI assigned
Jul 30, 2025
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 1207453 TX Primary

Addresses

Primary practice location

2910 Broadway Blvd Ste 102
Garland, TX 75041-3796

Mailing address

6960 Seabreeze Dr
Grand Prairie, TX 75054-7283
Phone (817) 226-0452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1207453TXMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1659254001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6960 SEABREEZE DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750547283",
            "telephone_number": "817-226-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BROADWAY BLVD STE 102",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750413796",
            "telephone_number": "240-547-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHABU",
        "first_name": "CLIFFORD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-30",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1207453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.