NPIMap

Organization Active NPI

Vital Medical Services, PA

  • Clinic/Center
  • Mesquite, TX
National Provider Identifier
1063596534
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
K1958 Issued in TX
Legal business name
VITAL MEDICAL SERVICES, PA
Practice address
1900 Oates Dr Ste 138
Mesquite, TX 75150-6802
Phone
(972) 270-7600
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Pedro Ruey-Ming Yen, M.D.NPI 1720163751
Title
Physician
Phone
(214) 328-2999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X K1958 TX Primary

Addresses

Primary practice location

1900 Oates Dr Ste 138
Mesquite, TX 75150-6802

Mailing address

2638 Lakeforest CT
Dallas, TX 75214-3881
Phone (214) 328-2999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120511000460 TX Part B Supplier - Clinic/Group Practice 5698938512 Receives reassigned benefits from 1 practitioner
Practice locations: Mesquite, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063596534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 LAKEFOREST CT",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143881",
            "telephone_number": "214-328-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 OATES DR STE 138",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506802",
            "telephone_number": "972-270-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL MEDICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YEN",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "RUEY-MING",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "214-328-2999",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "K1958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.