Provider Demographics
NPI:1386332898
Name:VITAL HOUSECALL LLC
Entity type:Organization
Organization Name:VITAL HOUSECALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-777-2703
Mailing Address - Street 1:515 WADE CT
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-2085
Mailing Address - Country:US
Mailing Address - Phone:214-777-2703
Mailing Address - Fax:817-865-1530
Practice Address - Street 1:1221 W AIRPORT FWY STE 209 UNIT B
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6209
Practice Address - Country:US
Practice Address - Phone:214-777-2703
Practice Address - Fax:817-865-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty