Provider Demographics
NPI:1629897467
Name:VITALITY HEALTH AND WELLNESS
Entity type:Organization
Organization Name:VITALITY HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-323-0033
Mailing Address - Street 1:6988 LEBANON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6743
Mailing Address - Country:US
Mailing Address - Phone:469-323-0033
Mailing Address - Fax:214-446-5304
Practice Address - Street 1:6988 LEBANON RD STE 101
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6743
Practice Address - Country:US
Practice Address - Phone:469-323-0033
Practice Address - Fax:214-446-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care