MEDICARE: VIVA MEDICAL GROUP, LLC

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
1	251E00000X	Home Health Agency	012429	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720231442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIVA MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	275 W CAMPBELL RD STE 400
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-3581
Country	:	US
Telephone Number	:	469-341-7772
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 W CAMPBELL RD STE 400
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-3581
Country	:	US
Telephone Number	:	469-341-7772
Fax Number	:	972-378-2111

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MR. EFREM L COLMENERO
Credential	:
Telephone Number	:	972-861-1000

Provider Enumeration Date	:	10/25/2008
Last Update Date	:	02/11/2026

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Directions to “VIVA MEDICAL GROUP, LLC ” Practice Location

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