VITALITY CLINICS OF EAST TEXAS, P.A. - NPI NUMBER 1508206442

Summary

Provider Name: VITALITY CLINICS OF EAST TEXAS, P.A.

NPI Number: 1508206442

NPI Type: Organization

Clasification: Family Medicine (207QA0505X)

Specialization: Adult Medicine

Address:
455 RICE RD
102
TYLER, TX
ZIP 75703

Phone Number: (903) 525-9432



Detailed Information

VITALITY CLINICS OF EAST TEXAS, P.A. is an adult family physician in Tyler, TX. The provider is definition to come. The assigned NPI number for this provider is 1508206442 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

455 RICE RD
102
TYLER, TX
ZIP 75703-604
Phone: (903) 525-9432
Fax: (903) 525-9455

The provider's authorized official is Steven Kip Yoder .
The authorized official title is Owner and has the following contact phone number (903) 525-9432.

The enumeration date for this NPI number is 6/25/2013 and was last updated on 6/25/2013.

Map - Location of Practice




This page was last updated on: 5/13/2015

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