Provider Demographics
NPI:1003625823
Name:ERES BELLA, PLLC
Entity type:Organization
Organization Name:ERES BELLA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GASIM
Authorized Official - Middle Name:HAMOUDA
Authorized Official - Last Name:BELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-804-3556
Mailing Address - Street 1:222 S BLISS AVE
Mailing Address - Street 2:
Mailing Address - City:DUMAS
Mailing Address - State:TX
Mailing Address - Zip Code:79029-3806
Mailing Address - Country:US
Mailing Address - Phone:806-672-9929
Mailing Address - Fax:806-553-1531
Practice Address - Street 1:5215 S COULTER ST STE 200
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6759
Practice Address - Country:US
Practice Address - Phone:806-672-9929
Practice Address - Fax:806-553-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center