MEDICARE: VIVA WELL ANESTHESIA PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1033975131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIVA WELL ANESTHESIA PLLC

Provider Business Mailing Address
First Line	:	2200 PARK BEND DR STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-5386
Country	:	US
Telephone Number	:	512-371-6398
Fax Number	:

Provider Business Practice Location Address
First Line	:	9010 BRODIE LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5186
Country	:	US
Telephone Number	:	512-371-6398
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VIVEK MAHENDRU
Credential	:	MD
Telephone Number	:	512-371-6398

Provider Enumeration Date	:	02/26/2024
Last Update Date	:	02/26/2024

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