Provider Demographics
NPI:1578320875
Name:SUVIDA THERAPY AND CONSULTING SERVICES, PLLC
Entity Type:Organization
Organization Name:SUVIDA THERAPY AND CONSULTING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ-LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:956-456-0064
Mailing Address - Street 1:2209 SPARROW RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5830
Mailing Address - Country:US
Mailing Address - Phone:956-456-0064
Mailing Address - Fax:
Practice Address - Street 1:2209 SPARROW RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5830
Practice Address - Country:US
Practice Address - Phone:956-456-0064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty