Vitality Medical Clinic, Pllc | |
25420 Kuykendahl Rd Ste B200-162 Tomball TX 77375-3405 | |
(832) 639-0374 | |
(321) 323-3740 |
Full Name | Vitality Medical Clinic, Pllc |
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Speciality | Internal Medicine |
Location | 25420 Kuykendahl Rd Ste B200-162, Tomball, Texas |
Authorized Official Name and Position | Megan Elizabeth Mohsin (CO-OWNER) |
Authorized Official Contact | 3863441538 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vitality Medical Clinic, Pllc 25420 Kuykendahl Rd Ste B200-162 Tomball TX 77375-3405 Ph: (832) 639-0374 | Vitality Medical Clinic, Pllc 25420 Kuykendahl Rd Ste B200-162 Tomball TX 77375-3405 Ph: (832) 639-0374 |
NPI Number | 1104693969 |
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Provider Enumeration Date | 12/11/2023 |
Last Update Date | 10/14/2024 |
Medicare PECOS PAC ID | 2163962168 |
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Medicare Enrollment ID | O20240905000516 |
Identifier | Type | State | Issuer |
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1104693969 | NPI | - | NPPES |
Provider Name | Jamal Mohsin |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1548600448 PECOS PAC ID: 6709029416 Enrollment ID: I20230918001439 |
Provider Name | Megan Mohsin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376257105 PECOS PAC ID: 8527429869 Enrollment ID: I20240905001041 |
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