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NPI Code Detail

MEDICARE: VIDA Y SALUD HEALTH SYSTEMS INC

MEDICARE: VIDA Y SALUD HEALTH SYSTEMS INC
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
1333600000XPharmacy
23336C0002XClinic Pharmacy07032TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14514798OTHEROTHER ID NUMBER
24514798OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1689616039
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIDA Y SALUD HEALTH SYSTEMS INC
Provider Business Mailing Address
First Line : 308 S CESAR CHAVEZ AVE
Second Line :
City : CRYSTAL CITY
State : TX
Zip : 78839-4200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 308 S CESAR CHAVEZ AVE
Second Line :
City : CRYSTAL CITY
State : TX
Zip : 78839-4200
Country : US
Telephone Number : 830-374-2301
Fax Number : 830-374-3364
Authorized Official
Title or Position : CHIEF FINANCE OFCR
Name : RAMON LOPEZ
Credential :
Telephone Number : 830-374-2301
Provider Enumeration Date : 06/11/2006
Last Update Date : 07/20/2007

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Practice Location Address:
308 S CESAR CHAVEZ AVE
CRYSTAL CITY, TX
78839-4200
Practice Phone: 830-374-2301
Practice Fax: 830-374-9368
1801905179 — ANTONIO H. RIVERA M.D.
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1760591168 — AHMAD EL-BJEIRAMI D.D.S.
Practice Location Address:
308 S. CESAR CHAVEZ AVE.
CRYSTAL CITY, TX
78839-4200
Practice Phone: 830-374-2301
Practice Fax: 830-374-3368
1841383908 — STEVEN PAUL GARZA P.A.
Practice Location Address:
308 S CESAR CHAVEZ AVE
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1558582171 — MARIA ELMA RIVERA CNM, FNP
Practice Location Address:
308 S CESAR CHAVEZ AVE
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78839-4200
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1023215159 — OLUYEMISI LADITAN D.D.S
Practice Location Address:
308 S CESAR CHAVEZ AVE
CRYSTAL CITY, TX
78839-4200
Practice Phone: 830-374-2301
Practice Fax: 830-374-9368

Directions to “VIDA Y SALUD HEALTH SYSTEMS INC ” Practice Location

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