NPIMap

Organization Active NPI

Vitality Center

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1023356524
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03127 Issued in TX
Legal business name
VITALITY CENTER
Practice address
14444 Eastside Rd
Tyler, TX 75707-6724
Phone
(214) 415-9334
NPI assigned
Jan 18, 2013
Last updated
Jan 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Harrison Lewis, PANPI 1184972994
Title
Physician Assistant
Phone
(214) 415-9334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03127 TX Primary

Addresses

Primary practice location

14444 Eastside Rd
Tyler, TX 75707-6724

Mailing address

14444 Eastside Dr.
Tyler, TX 75707

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1023356524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14444 EASTSIDE DR.",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14444 EASTSIDE RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757076724",
            "telephone_number": "214-415-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-18",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "HARRISON",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "214-415-9334",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.