Active NPI
Clinica Vida Sana LLC
- Family Medicine Physician
- Houston, TX
National Provider Identifier
1790514032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CLINICA VIDA SANA LLC
- Practice address
- 9555 Wilcrest Dr Ste a
Houston, TX 77099-2169 - Phone
- (281) 809-3055
- Fax
- (281) 809-3843
- NPI assigned
- Jul 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph Augustine Montes, MD
- Title
- Medical Director
- Phone
- (713) 725-2777
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
9555 Wilcrest Dr Ste a
Houston, TX 77099-2169
Mailing address
9555 Wilcrest Dr Ste a
Houston, TX 77099-2169
Phone (281) 809-3055
Other practice location 1
8138 S Kirkwood Rd Ste C
Houston, TX 77072-3724
Phone (832) 295-3571
Other names 1
- Clinica Vida Sana LLC
National Provider Directory
National Provider Directory- Tax ID family
- Clinica Hispana San Juan
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Houston, TX
- NPI 1023822897
Locations
9555 Wilcrest Dr
#A
Houston, TX 77099
Phone (281) 809-3055
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Family Medicine Physician
- Houston, TX
- NPI 1023822897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721952000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724976000000",
"number": "1790514032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9555 WILCREST DR STE A",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770992169",
"telephone_number": "281-809-3055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 WILCREST DR STE A",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770992169",
"telephone_number": "281-809-3055",
"fax_number": "281-809-3843"
}
],
"practiceLocations": [
{
"address_1": "8138 S Kirkwood Rd Ste C",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770723724",
"country_code": "US",
"telephone_number": "832-295-3571",
"fax_number": "832-295-3579",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CLINICA VIDA SANA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-07-26",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A",
"authorized_official_last_name": "MONTES",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "AUGUSTINE",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "713-725-2777",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Clinica Vida Sana LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.