Provider Demographics
NPI:1316462690
Name:VITALITY MEDICAL AND WELLNESS PLLC
Entity type:Organization
Organization Name:VITALITY MEDICAL AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:SINOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-618-9622
Mailing Address - Street 1:5757 WARREN PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4273
Mailing Address - Country:US
Mailing Address - Phone:214-618-9622
Mailing Address - Fax:214-618-7997
Practice Address - Street 1:5757 WARREN PKWY STE 110
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4273
Practice Address - Country:US
Practice Address - Phone:214-618-9622
Practice Address - Fax:214-618-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8208208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty