Provider Demographics
NPI:1275123408
Name:BELLA & SLZ LLC
Entity Type:Organization
Organization Name:BELLA & SLZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERLYS
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-996-6911
Mailing Address - Street 1:3810 N FRY RD SUITE 118
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449
Mailing Address - Country:US
Mailing Address - Phone:832-321-4233
Mailing Address - Fax:832-321-4310
Practice Address - Street 1:3810 N FRY RD SUITE 118
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:832-321-4233
Practice Address - Fax:832-321-4310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2023-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty