Organization Active NPI

Polished Mind Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Euless, TX
National Provider Identifier
1811626849
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
POLISHED MIND PSYCHIATRY PLLC
Practice address
1401 Royal Pkwy Ste C
Euless, TX 76040-6725
Phone
(214) 378-5577
Fax
(214) 983-1110
NPI assigned
Jun 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Modupeoluwa Odu-OnikosiNPI 1689261513
Title
Ceo
Phone
(214) 960-6652

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1401 Royal Pkwy Ste C
Euless, TX 76040-6725

Mailing address

1401 Royal Pkwy Ste C
Euless, TX 76040-6725
Phone (214) 378-5577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220623001448 TX Part B Supplier - Clinic/Group Practice 6709265689 Receives reassigned benefits from 2 practitioners
Practice locations: Euless, TX

National Provider Directory

National Provider Directory

Locations

1401 Royal Pkwy
Ste C
Euless, TX 76040
Phone (214) 378-5577

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1811626849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 ROYAL PKWY STE C",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760406725",
            "telephone_number": "214-378-5577",
            "fax_number": "214-983-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 ROYAL PKWY STE C",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760406725",
            "telephone_number": "214-378-5577",
            "fax_number": "214-983-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLISHED MIND PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "ODU-ONIKOSI",
        "authorized_official_first_name": "MODUPEOLUWA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-960-6652"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euless, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.