Provider Demographics
NPI:1164968350
Name:BELLISSIMA WOMEN'S CLINIC
Entity Type:Organization
Organization Name:BELLISSIMA WOMEN'S CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-692-0600
Mailing Address - Street 1:415 W LITTLE YORK RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1349
Mailing Address - Country:US
Mailing Address - Phone:713-692-0600
Mailing Address - Fax:713-699-9352
Practice Address - Street 1:415 W LITTLE YORK RD
Practice Address - Street 2:SUITE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-1349
Practice Address - Country:US
Practice Address - Phone:713-692-0600
Practice Address - Fax:713-699-9352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX393469Medicare UPIN