| Family Center Vitalehealth Pllc | |
|
1020 Flower Mound Rd Ste 100 Flower Mound TX 75028-3440 | |
| (972) 410-0042 | |
| (972) 410-0044 |
| Full Name | Family Center Vitalehealth Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1020 Flower Mound Rd Ste 100, Flower Mound, Texas |
| Authorized Official Name and Position | Joseph M Kim (CEO) |
| Authorized Official Contact | 9724100042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Center Vitalehealth Pllc 1020 Flower Mound Rd Ste 100 Flower Mound TX 75028-3440 Ph: (972) 410-0024 | Family Center Vitalehealth Pllc 1020 Flower Mound Rd Ste 100 Flower Mound TX 75028-3440 Ph: (972) 410-0042 |
| NPI Number | 1174025746 |
|---|---|
| Provider Enumeration Date | 02/28/2018 |
| Last Update Date | 06/20/2024 |
| Medicare PECOS PAC ID | 9931463916 |
|---|---|
| Medicare Enrollment ID | O20180426002561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174025746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | May Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386844744 PECOS PAC ID: 9537200779 Enrollment ID: I20150527001980 |
| Provider Name | Jimi Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730884990 PECOS PAC ID: 3476991480 Enrollment ID: I20240409003661 |
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