Organization Active NPI

Fendeviv Health and Wellness Center PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Desoto, TX
National Provider Identifier
1245053651
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FENDEVIV HEALTH AND WELLNESS CENTER PLLC
Practice address
1736 River Run Dr
Desoto, TX 75115-0108
Phone
(682) 365-3840
NPI assigned
Nov 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vivian SonaNPI 1902358377
Title
Owner
Phone
(682) 365-3840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1736 River Run Dr
Desoto, TX 75115-0108

Mailing address

1736 River Run Dr
Desoto, TX 75115-0108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1245053651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 RIVER RUN DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751150108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 RIVER RUN DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751150108",
            "telephone_number": "682-365-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENDEVIV HEALTH AND WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "SONA",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-365-3840"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.