Organization
VIVA DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNETTE OLAZAGASTI LOURIDO MD (DERMATOLOGIST)
(817) 754-8884
Entity
Organization
Contact information
Practice address
601 WESTPARK WAY STE 100, EULESS, TX 76040-3972
(817) 754-8884
(817) 754-8885
Mailing address
601 WESTPARK WAY STE 100, EULESS, TX 76040-3972
(817) 754-8884
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
07/28/2023
Last updated
11/06/2023
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