| Vitavia Telemedicine Pllc | |
|
1301 W League City Pkwy League City TX 77573-6313 | |
| (445) 213-8818 | |
| (281) 994-7461 |
| Full Name | Vitavia Telemedicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1301 W League City Pkwy, League City, Texas |
| Authorized Official Name and Position | Azfar Syed (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4452138818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitavia Telemedicine Pllc 1301 W League City Pkwy League City TX 77573-6313 Ph: (445) 213-8818 | Vitavia Telemedicine Pllc 1301 W League City Pkwy League City TX 77573-6313 Ph: (445) 213-8818 |
| NPI Number | 1942891478 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 04/12/2023 |
| Medicare PECOS PAC ID | 3870950116 |
|---|---|
| Medicare Enrollment ID | O20230601001409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942891478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Azfar Syed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447646559 PECOS PAC ID: 0446521793 Enrollment ID: I20181206000797 |
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