Provider Demographics
NPI:1376832410
Name:A&R VIDA
Entity Type:Organization
Organization Name:A&R VIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-585-5422
Mailing Address - Street 1:2017 N CONWAY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2965
Mailing Address - Country:US
Mailing Address - Phone:956-585-5422
Mailing Address - Fax:800-680-2738
Practice Address - Street 1:2017 N CONWAY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2965
Practice Address - Country:US
Practice Address - Phone:956-585-5422
Practice Address - Fax:800-680-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies