Provider Demographics
NPI:1073492278
Name:VITALITY HEALTH PARTNERS PLLC
Entity type:Organization
Organization Name:VITALITY HEALTH PARTNERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-571-5749
Mailing Address - Street 1:3515 LONGMIRE DR STE B120
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 COOPERATIVE WAY STE 405
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-8208
Practice Address - Country:US
Practice Address - Phone:979-571-5749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty