Healthcare Provider Details

I. General information

NPI: 1760665756
Provider Name (Legal Business Name): VIDA HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 W UNIVERSITY DR
EDINBURG TX
78539-2832
US

IV. Provider business mailing address

2024 W UNIVERSITY DR
EDINBURG TX
78539-2832
US

V. Phone/Fax

Practice location:
  • Phone: 956-624-3852
  • Fax: 956-316-0156
Mailing address:
  • Phone: 956-316-0153
  • Fax: 956-316-0156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number121016
License Number StateTX

VIII. Authorized Official

Name: MS. ALEJANDRINA S. VELA
Title or Position: OWNER
Credential:
Phone: 956-316-0153