Viva Health Clinic, LLC
Nurse Practitioner in Round Rock, TX. Organization (NPI-2).
NPI number1417618281
StatusActive
Last updated in NPPESSep 20, 2023
Details
- NPI
- 1417618281
- Entity type
- Organization (NPI-2)
- Legal business name
- Viva Health Clinic, LLC
- Organization subpart
- No
- Enumeration date
- Jan 4, 2022
- Certification date
- Sep 20, 2023
- Last updated
- Sep 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Other names
- Viva Health Clinic, LLC (Doing Business As)
Practice location
2631 Gattis School Rd Ste 150Round Rock, TX 78664-2825
Phone 512-243-5872 · Fax 512-243-7130
Mailing address
3130 Jazz StRound Rock, TX 78664-7219
Phone 512-903-6741
Authorized official
Ernesto Marrero
Owner
5122435872
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