| Vitality Weight Loss And Wellness Institute, Pllc | |
|
6201 Dallas Parkway Suite 210 Plano TX 75093 | |
| (972) 597-1639 | |
| Not Available |
| Full Name | Vitality Weight Loss And Wellness Institute, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6201 Dallas Parkway, Plano, Texas |
| Authorized Official Name and Position | Ruby J Shah (MEMBER MANAGER) |
| Authorized Official Contact | 9513142930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Weight Loss And Wellness Institute, Pllc 5760 Legacy Dr Ste B3-424 Plano TX 75024-7102 Ph: (951) 314-2930 | Vitality Weight Loss And Wellness Institute, Pllc 6201 Dallas Parkway Suite 210 Plano TX 75093 Ph: (972) 597-1639 |
| NPI Number | 1710347737 |
|---|---|
| Provider Enumeration Date | 03/03/2016 |
| Last Update Date | 03/15/2022 |
| Medicare PECOS PAC ID | 0345530333 |
|---|---|
| Medicare Enrollment ID | O20160603000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710347737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | Q6034 (Texas) | Primary |
| Provider Name | Rishin Dinesh Shah |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1811101512 PECOS PAC ID: 8022141605 Enrollment ID: I20150929002485 |
| Provider Name | Ruby J Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003134974 PECOS PAC ID: 1456593433 Enrollment ID: I20151214000942 |
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