Organization · Type 2 NPI

Southlake Foot & Wellness Center LLC

Specialist · Colleyville, TX

NPI number 1154824209 Active

Practice location

6407 Colleyville Blvd Ste B
Colleyville, TX 76034-6279

Call (817) 527-6077 Map

Fax (817) 796-1694

Mailing address

901 W Wall St Ste 103
Grapevine, TX 76051-7419

Specialties and licenses

Taxonomy	Code	License
Specialist Primary	174400000X	AC00108 (TX)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Another provider at this address

Stat Sleep of Colleyville, LLPSleep Disorder Diagnostic Clinic/Center Colleyville, TX NPI 1013305978

Other specialist providers in Colleyville

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NPI record

NPI: 1154824209
Entity type: Organization (Type 2)
Issued: Mar 15, 2018
Last updated: Oct 5, 2023
Status: Active

Other names

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Vitality Wellness Clinic · doing business as
Vitality Wellness Clinic · doing business as
Vitality Wellness Clinic · other name

Authorized official

Vitality Wellness Clinic
Owner
(817) 527-6077

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1154824209

Southlake Foot & Wellness Center LLC's National Provider Identifier is 1154824209, issued on Mar 15, 2018. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Colleyville, TX. The record was last updated on Oct 5, 2023.