Provider Demographics
NPI:1285010702
Name:YOSVENMA LLC
Entity Type:Organization
Organization Name:YOSVENMA LLC
Other - Org Name:CLINICA HISPANA LA FAMILIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ENMA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CORDERO RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-261-4753
Mailing Address - Street 1:4520 W 34TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-5938
Mailing Address - Country:US
Mailing Address - Phone:713-688-1762
Mailing Address - Fax:713-688-1782
Practice Address - Street 1:4520 W 34TH ST STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-5938
Practice Address - Country:US
Practice Address - Phone:713-688-1762
Practice Address - Fax:713-688-1782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WP2201X, 207R00000X, 363LP0808X
TXH0649207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory CareGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty