Healthcare Provider Details

I. General information

NPI: 1326800103
Provider Name (Legal Business Name): VIVA HEALTHCARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 E CORPORATE DR
ARLINGTON TX
76006-6105
US

IV. Provider business mailing address

1217 E CORPORATE DR
ARLINGTON TX
76006-6105
US

V. Phone/Fax

Practice location:
  • Phone: 817-975-8355
  • Fax: 844-929-1560
Mailing address:
  • Phone: 817-975-8355
  • Fax: 844-929-1560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: SHAWN LETT
Title or Position: OWNER
Credential: DC
Phone: 817-975-8355