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General NPI Number Information
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NPI Number | 1851105357
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Entity Type | Organization
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Legal Business Name | HEALTHY VIDA CLINIC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 421 S 77 SUNSHINESTRIP STE F
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City | HARLINGEN
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State | TX
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Zip | 78550-7450
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Country | US
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Telephone | 956-230-6695
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Fax | 866-529-1725
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Provider Business Mailing Address
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Address Line | 421 S 77 SUNSHINESTRIP STE F
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City | HARLINGEN
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State | TX
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Zip | 78550-7450
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Country | US
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Telephone | 956-300-1985
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Fax | 866-529-1725
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | VANESSA COBARRUBIAS
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Credential | PA-C
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Telephone | 956-300-1985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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