Bella Vida DME , LLC.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BELLA VIDA DME , LLC.

Practice address

2604 N Raul Longoria Rd Ste 104
San Juan, TX 78589-4212

Phone

(956) 867-3782

Fax

(956) 715-8017

NPI assigned

Oct 5, 2020

Organization subpart

No

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

Authorized official

Name

Nickie Mae Ybarra

Title

Ceo

Phone

(956) 867-3782

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1396342143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 N RAUL LONGORIA RD STE 104",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785894212",
            "telephone_number": "956-867-3782",
            "fax_number": "956-715-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 N RAUL LONGORIA RD STE 104",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785894212",
            "telephone_number": "956-867-3782",
            "fax_number": "956-715-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA VIDA DME , LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "YBARRA",
        "authorized_official_first_name": "NICKIE",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "956-867-3782"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in San Juan, TX
• Providers in San Juan, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.