| Vivede Inc | |
|
359 Keller Pkwy Keller TX 76248-2206 | |
| (817) 431-6995 | |
| Not Available |
| Full Name | Vivede Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 359 Keller Pkwy, Keller, Texas |
| Authorized Official Name and Position | Deepa Venugopal (CEO) |
| Authorized Official Contact | 3135491401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivede Inc 1508 Cherry Glow Ct Keller TX 76248-2034 Ph: (313) 549-1401 | Vivede Inc 359 Keller Pkwy Keller TX 76248-2206 Ph: (817) 431-6995 |
| NPI Number | 1780169086 |
|---|---|
| Provider Enumeration Date | 10/02/2018 |
| Last Update Date | 10/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780169086 | NPI | - | NPPES |
| 30974 | Other | TX | TEXAS DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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