Viva Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

VIVA DERMATOLOGY PLLC

Practice address

601 Westpark Way Ste 100
Euless, TX 76040-3972

Phone

(817) 754-8884

Fax

(817) 754-8885

NPI assigned

Jul 28, 2023

Last updated

Nov 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeannette Olazagasti Lourido, MDNPI 1104288778

Title

Dermatologist

Phone

(817) 754-8884

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeannette Marie Olazagasti Lourido, M.D., M.S.

  • Dermatology Physician
  • Euless, TX
  • NPI 1104288778
  Authorized official Same address or phone

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1326729682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WESTPARK WAY STE 100",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403972",
            "telephone_number": "817-754-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WESTPARK WAY STE 100",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403972",
            "telephone_number": "817-754-8884",
            "fax_number": "817-754-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "OLAZAGASTI LOURIDO",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "817-754-8884",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Euless, TX
• Providers in Euless, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.