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Organization
VIVA PEDIATRICS PA
Active
Organization
VIVA PEDIATRICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO CUELLAR MD (MD PRESIDENT)
(210) 977-9080
Entity
Organization
Contact information
Practice address
7430 BARLITE BLVD SUITE 104, SAN ANTONIO, TX 78224-1366
(210) 977-9080
(210) 977-8480
Mailing address
7430 BARLITE BLVD SUITE 104, SAN ANTONIO, TX 78224-1366
(210) 977-9080
(210) 977-8480
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D1659
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D1659
LICESNSE
TX
Enumeration date
01/08/2007
Last updated
06/16/2008
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