Provider Demographics
NPI:1750568838
Name:VIVERE HEALTH DALLAS, LLC
Entity type:Organization
Organization Name:VIVERE HEALTH DALLAS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-969-7391
Mailing Address - Street 1:720 COOL SPRINGS BLVD.
Mailing Address - Street 2:SUITE 520
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:615-550-4900
Mailing Address - Fax:615-550-4901
Practice Address - Street 1:12606 GREENVILLE AVE
Practice Address - Street 2:SUITE 190
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1921
Practice Address - Country:US
Practice Address - Phone:866-475-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIVERE HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-30
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical