| Vitality Clinics Of East Texas, P.a. | |
|
455 Rice Rd 102 Tyler TX 75703-3604 | |
| (903) 525-9432 | |
| (903) 525-9455 |
| Full Name | Vitality Clinics Of East Texas, P.a. |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 455 Rice Rd, Tyler, Texas |
| Authorized Official Name and Position | Steven Kip Yoder (OWNER) |
| Authorized Official Contact | 9035259432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Clinics Of East Texas, P.a. 455 Rice Rd 102 Tyler TX 75703-3604 Ph: (903) 525-9432 | Vitality Clinics Of East Texas, P.a. 455 Rice Rd 102 Tyler TX 75703-3604 Ph: (903) 525-9432 |
| NPI Number | 1508206442 |
|---|---|
| Provider Enumeration Date | 06/25/2013 |
| Last Update Date | 06/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508206442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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