Organization Name: | VIDA Y SALUD-HEALTH SYSTEMS INC |
NPI Number: | 1770511032 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NORA TELLEZ (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 308 S Cesar Chavez Ave Crystal City |
State: | TX US |
Postal Code: | 788394200 |
Phone Number: | 8303742301 |
Fax Number: | 8303749368 |
NPI Enumeration Date: | 06/28/2006 |
NPI Last Update Date: | 07/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |