Individual provider Active NPI

Idowu Awosere, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1659691285
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1018462 Issued in TX
Practice address
9708 Skillman St
Dallas, TX 75243-5150
Phone
(214) 221-5433
NPI assigned
Jun 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 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 Practitioner 363LP0808X 1018462 TX Primary

Addresses

Primary practice location

9708 Skillman St
Dallas, TX 75243-5150

Mailing address

10586 Shire View Dr
Frisco, TX 75035-9192

Other practice location 1

4701 Samuell Blvd
Dallas, TX 75228-6828
Phone (972) 861-5611

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
I20210115001106 TX Practitioner - Nurse Practitioner 3072926823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9708 Skillman St
Dallas, TX 75243-5150
Phone (214) 743-6159

Merit-based Incentive Payment System (MIPS)

Final score
75.31 of 100Reported as group
Quality
56.91
Promoting interoperability
52
Improvement activities
40
Cost
84.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1018462TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Mental Health & Mental Retardation Center CurrentSince Nov 11, 2020 Accepting new patients
Preston Creek Healthcare LLC Past Accepting new patients

Locations

1345 River Bend Dr
Ste 200
Dallas, TX 75247
Phone (214) 743-1201

4701 Samuell Blvd
Dallas, TX 75228
Phone (214) 381-7070

4645 Samuell Blvd
Dallas, TX 75228
Phone (214) 275-7393

9708 Skillman St
Dallas, TX 75243
Phone (214) 221-5433

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": "1275696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1659691285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10586 SHIRE VIEW DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750359192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9708 SKILLMAN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435150",
            "telephone_number": "214-221-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 Samuell Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752286828",
            "country_code": "US",
            "telephone_number": "972-861-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWOSERE",
        "first_name": "IDOWU",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-05",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1018462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.