| Vital Care Family Practice | |
|
4400 N Midland Dr 406b Midland TX 79707-3385 | |
| (432) 704-5663 | |
| (432) 704-5660 |
| Full Name | Vital Care Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 4400 N Midland Dr, Midland, Texas |
| Authorized Official Name and Position | Candace D Wynne (BILLING) |
| Authorized Official Contact | 4327045663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Care Family Practice Po Box 4467 Midland TX 79704-4467 Ph: (432) 704-5663 | Vital Care Family Practice 4400 N Midland Dr 406b Midland TX 79707-3385 Ph: (432) 704-5663 |
| NPI Number | 1528504065 |
|---|---|
| Provider Enumeration Date | 01/09/2017 |
| Last Update Date | 01/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528504065 | NPI | - | NPPES |
| 1144696436 | Other | TX | NPI |
| 1417224403 | Other | TX | NPI |
| 1811334105 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | AP121037 (Texas) | Secondary |
| 207Q00000X | Family Medicine | AP128857 (Texas) | Secondary |
| 207Q00000X | Family Medicine | Q7356 (Texas) | Primary |
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