| NPI | 1790514032 |
|---|---|
| Former Legal Business Name | CLINICA VIDA SANA LLC |
| Entity Type | Organization |
| Authorized Contact | JOSEPH AUGUSTINE MONTES Medical Director 713-725-2777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2024-08-30 |