Provider Demographics
NPI:1558412718
Name:VITE, LORENZO (PT)
Entity Type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:VITE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6051 ALMA RD
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2139
Mailing Address - Country:US
Mailing Address - Phone:972-359-0534
Mailing Address - Fax:972-359-0628
Practice Address - Street 1:6051 ALMA DRIVE
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-359-0534
Practice Address - Fax:972-359-0628
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1066074225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX816T71OtherBCBS
TX8T8114OtherBCBS
TX8T2205OtherBCBS - TEXAS
TX8L18811Medicare PIN