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VIVA HEALTH CLINIC LLC NPI 1417618281


NPI Information

NPI: 1417618281
Provider Name: VIVA HEALTH CLINIC, LLC

Doing Business As: VIVA HEALTH CLINIC, LLC

Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization

CLIA Number: 45D2285950

Address:
2631 GATTIS SCHOOL RD STE 150
ROUND ROCK, TX
ZIP 78664
Phone: (512) 243-5872
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VIVA HEALTH CLINIC, LLC is a nurse practitioner in Round Rock, TX. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. VIVA HEALTH CLINIC, LLC NPI is 1417618281. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Viva Health Clinic, Llc.

The provider's business location address is:

2631 GATTIS SCHOOL RD STE 150
ROUND ROCK, TX
ZIP 78664-825
Phone: (512) 243-5872
Fax: (512) 243-7130

The provider's authorized official is Ernesto Marrero .
The authorized official title is Owner and has the following contact phone number (512) 243-5872.

The CLIA number assigned to this NPI record is 45D2285950 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/4/2022 and was last updated on 9/20/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
128496155MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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