VITALITY CARE LLC NPI 1093320996

NPI Information

  • NPI: 1093320996
  • Provider Name: VITALITY CARE LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 45D2293957
  • Address: 6302 BROADWAY ST STE 130
    PEARLAND, TX
    ZIP 77581
  • Phone: (832) 913-1118

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NPI Details

VITALITY CARE LLC is a family nurse practitioner in Pearland, TX. VITALITY CARE LLC NPI is 1093320996. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6302 BROADWAY ST STE 130
PEARLAND, TX
ZIP 77581-859
Phone: (832) 913-1118
Fax: (832) 575-5494

The provider's authorized official is Kimberly Wingard .
The authorized official title is Owner and has the following contact phone number (832) 913-1118.

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 5/29/2024.

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
1363LF0000XNurse PractitionerFamilyYes
2363LP0808XNurse PractitionerPsychiatric/Mental HealthNo

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: 3/30/2025

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