Provider Demographics
NPI:1881032621
Name:LEYVA-TSYCHUYEVA, VIRIDIANA (DC)
Entity Type:Individual
Prefix:DR
First Name:VIRIDIANA
Middle Name:
Last Name:LEYVA-TSYCHUYEVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:VIRIDIANA
Other - Middle Name:
Other - Last Name:LEYVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1617 FANNIN ST
Mailing Address - Street 2:SUITE 902
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-2944
Mailing Address - Country:US
Mailing Address - Phone:713-300-0327
Mailing Address - Fax:713-300-0327
Practice Address - Street 1:1617 FANNIN ST
Practice Address - Street 2:#902
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-7647
Practice Address - Country:US
Practice Address - Phone:713-300-0327
Practice Address - Fax:713-300-0327
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX312042YURUMedicare PIN