VITALITY CARE LLC NPI 1093320996

NPI Information

NPI: 1093320996
Provider Name: VITALITY CARE LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D2293957

Address:
2646 S LOOP W STE 220
HOUSTON, TX
ZIP 77054
Phone: (832) 342-6326
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VITALITY CARE LLC is a primary care nurse practitioner in Houston, TX. VITALITY CARE LLC NPI is 1093320996. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2646 S LOOP W STE 220
HOUSTON, TX
ZIP 77054-640
Phone: (832) 342-6326
Fax: (832) 575-5494

The provider's authorized official is Kimberly Wingard .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (713) 213-2717.

The CLIA number assigned to this NPI record is 45D2293957 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2020 and was last updated on 6/27/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				No
2	363LP2300X	Nurse Practitioner	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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