VITALITY CENTER (NPI# 1023356524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023356524 |
| Entity Type | Organization |
| Organization Name | VITALITY CENTER |
| Practice Address |
14444 Eastside Rd Tyler TX 75707-6724 |
| Mailing Address |
14444 Eastside Dr. Tyler TX 75707 |
| Practice Telephone | 2144159334 |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2013-01-18 |
| Authorized Official Name | MR. HARRISON LEWIS (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 2144159334 |
| Authorized Official Credential | PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA03127 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VITALITY CENTER, INC., THE | 3740 Idaho St, Elko, NV 89801-4611 |
| Street Address |
14444 EASTSIDE RD |
| City | TYLER |
| State | TX |
| Zip Code | 75707-6724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063916351 | Veronica Miller | Registered Nurse | 3928 Mobley Lane, Tyler, TX 75707 | 2018-03-21 |
| 1023548187 | Juan Fernando Melgoza Jr. | Specialist/Technologist | 13172 Tx-64, Tyler, TX 75707 | 2017-06-12 |
| 1396291969 | The Center At Grande, LLC | Skilled Nursing Facility | 3219 East Grande Blvd, Tyler, TX 75707 | 2016-09-01 |
| 1730432493 | Michelle Tucker | Clinic/Center | 5011 Troup Hwy Ste 100, Tyler, TX 75707 | 2012-10-18 |
| 1275724569 | Johnson Chiropractic Center | Chiropractor | 5400 University Blvd, 103, Tyler, TN 75707 | 2007-08-05 |
| 1104851096 | Raymond F Jordan | Family Medicine | 12295 Hwy. 64 E, Tyler, TX 75707 | 2006-07-11 |
| 1033514096 | David Comins Wheeler | Counselor | 5875 Grace Ave, Tyler, TX 75707-0006 | 2014-11-01 |
| 1497318968 | Haley Lynn Dominy | Licensed Vocational Nurse | 6028 Grace Ave, Tyler, TX 75707-0007 | 2019-04-19 |
| 1710947957 | Doug Hodde | Family Medicine | 3593 E Grande Blvd, Tyler, TX 75707-1400 | 2006-03-23 |
| 1851839120 | Trinity Clinic | Clinic/Center | 3593 E Grande Blvd, Tyler, TX 75707-1400 | 2017-02-07 |
| Find all providers in zip 75707 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129997 | Elizabeth Niedrauer | Physician Assistant | 2314 S Kennedy Ave, Tyler, TX 75701-5242 | 2020-06-25 |
| 1629489042 | Lifetime Health Center | Physician Assistant | 1420 Wsw Loop 323, Suite 100, Tyler, TX 75701-9347 | 2014-05-20 |
| 1407273428 | East Texas Physician Assistant Services | Physician Assistant | 5380 Old Bullard Rd Ste 600-125, Tyler, TX 75703-3607 | 2014-03-27 |
| 1790029007 | John M Mclean | Physician Assistant | 3700 Mcdonald Rd, Apt 260, Tyler, TX 75701-6253 | 2012-11-27 |
| 1124058524 | David Beck | Physician Assistant | 1133 Medical Dr, Tyler, TX 75701-2130 | 2006-07-03 |
| 1467444141 | Thomas R Scholler | Physician Assistant | 703 S Fleishel Ave, Tyler, TX 75701-2015 | 2005-08-18 |
| 1376535054 | Stephanie S Carter | Physician Assistant | 703 S Fleishel Ave Ste 4000, Tyler, TX 75701 | 2005-08-18 |
| 1992797799 | Matthew M Hand | Physician Assistant | 619 S Fleishel Ave, Suite 101, Tyler, TX 75701-2004 | 2005-08-17 |
| 1518962299 | Nina Beth Partin | Physician Assistant | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2005-06-17 |
| 1992708291 | Sigal Heart Center, P.a. | Physician Assistant | 820 S Baxter Ave, Tyler, TX 75701-2225 | 2005-05-31 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.