Mi Vida Primary Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP126924 Issued in TX

Legal business name

MI VIDA PRIMARY CARE LLC

Practice address

3318 N 21St St
McAllen, TX 78501-6062

Phone

(956) 789-5515

Fax

(361) 396-1283

NPI assigned

Jun 10, 2015

Organization subpart

No

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

Authorized official

Name

Mr. John L Pena

Title

Partner

Phone

(956) 789-5515

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1487035093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 N 21ST ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016062",
            "telephone_number": "956-789-5515",
            "fax_number": "361-396-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3318 N 21ST ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016062",
            "telephone_number": "956-789-5515",
            "fax_number": "361-396-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI VIDA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "956-789-5515",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP126924",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": "TX",
            "license": "AP126924",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126924",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP126924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mi Maranatha Home Health, Inc.
• Mi Medex Inc. (Medex Home Health Care)
• Mi Piquito de Oro Home Health LLC
• Mi Valle Health Care, LLC (Only Love PCS & Provider Care Services)
• Mi Vida Care Center RGV, LLC (Mi Vida Care Center)
• Mi Vida Primary Care LLC
• Mia Mariposa Home Health Care
• Shoaib Mian
• Cristelle Marie Miana, OTR
• Bayard Michel

• Family Nurse Practitioner in McAllen, TX
• Providers in McAllen, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.