Provider Demographics
NPI:1043001332
Name:BELLAVITA INFUSION SERVICES PLLC
Entity type:Organization
Organization Name:BELLAVITA INFUSION SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ORDONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-674-3007
Mailing Address - Street 1:16922 KYLER CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-5220
Mailing Address - Country:US
Mailing Address - Phone:832-674-3007
Mailing Address - Fax:
Practice Address - Street 1:16922 KYLER CREEK TRL
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-5220
Practice Address - Country:US
Practice Address - Phone:832-674-3007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251E00000XAgenciesHome Health