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General NPI Number Information
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NPI Number | 1275123408
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Entity Type | Organization
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Legal Business Name | BELLA & SLZ LLC
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 01/01/2023
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Provider Practice Location Address
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Address Line | 3810 N FRY RD SUITE 118
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City | KATY
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State | TX
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Zip | 77449
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Country | US
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Telephone | 832-321-4233
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Fax | 832-321-4310
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Provider Business Mailing Address
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Address Line | 3810 N FRY RD SUITE 118
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City | KATY
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State | TX
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Zip | 77449
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Country | US
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Telephone | 832-321-4233
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Fax | 832-321-4310
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Authorized Official
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Title or Position | OWNER
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Name | JERLYS SUAREZ LOPEZ
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Credential | FNP
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Telephone | 832-996-6911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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