Provider Demographics
NPI:1811426216
Name:HIGHER GROUND SERVICES LLC
Entity type:Organization
Organization Name:HIGHER GROUND SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:EGYAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-251-0711
Mailing Address - Street 1:624 YOSEMITE TRL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-2583
Mailing Address - Country:US
Mailing Address - Phone:469-251-0711
Mailing Address - Fax:469-213-3022
Practice Address - Street 1:1675 REPUBLIC PKWY STE 190A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6902
Practice Address - Country:US
Practice Address - Phone:469-251-0711
Practice Address - Fax:469-213-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX868398OtherRN LICENSE
TXAP140039OtherNP LICENSE