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VITALITY CLINICS OF EAST TEXAS P.A. NPI 1508206442

NPI Profile

NPI: 1508206442

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

Classification: Family Medicine - 207QA0505X

Entity Type: Organization

Specialization: Adult Medicine

Address:
455 RICE RD
102
TYLER, TX
ZIP 75703

Phone: (903) 525-9432

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

The provider's business location 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

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 207QA0505X Family Medicine Adult Medicine 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: 7/13/2015