Provider Demographics
NPI:1225650468
Name:VITAL PHYSICIAN HOUSE CALLS LLC
Entity Type:Organization
Organization Name:VITAL PHYSICIAN HOUSE CALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MANSOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:972-900-0207
Mailing Address - Street 1:275 W CAMPBELL RD STE 325E
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3601
Mailing Address - Country:US
Mailing Address - Phone:972-666-0786
Mailing Address - Fax:972-666-0535
Practice Address - Street 1:275 W CAMPBELL RD STE 325E
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3601
Practice Address - Country:US
Practice Address - Phone:972-666-0786
Practice Address - Fax:972-666-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-11
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty