Provider Demographics
NPI:1851105357
Name:HEALTHY VIDA CLINIC
Entity type:Organization
Organization Name:HEALTHY VIDA CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:COBARRUBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:956-230-6695
Mailing Address - Street 1:1614 W FILMORE AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6262
Mailing Address - Country:US
Mailing Address - Phone:956-230-6695
Mailing Address - Fax:866-529-1725
Practice Address - Street 1:1614 W FILMORE AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6262
Practice Address - Country:US
Practice Address - Phone:956-230-6695
Practice Address - Fax:866-529-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center