Provider Demographics
NPI:1811060460
Name:VIVIS INC
Entity type:Organization
Organization Name:VIVIS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUPUY
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:214-221-2525
Mailing Address - Street 1:7920 BELT LINE RD
Mailing Address - Street 2:SUITE # 120
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8145
Mailing Address - Country:US
Mailing Address - Phone:214-221-2525
Mailing Address - Fax:214-446-2323
Practice Address - Street 1:7920 BELT LINE RD
Practice Address - Street 2:SUITE # 120
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-8145
Practice Address - Country:US
Practice Address - Phone:214-221-2525
Practice Address - Fax:214-446-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001634225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX47JWOtherBLUE CROSS