Victory Weight Loss Medical Services PLLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

VICTORY WEIGHT LOSS MEDICAL SERVICES PLLC

Practice address

5900 Balcones Dr Ste 100
Austin, TX 78731-4298

Phone

(512) 318-2199

NPI assigned

Aug 17, 2026

Organization subpart

No

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

Authorized official

Name

Matt Boutte, PA-C

Title

Co-Owner

Phone

(469) 877-6278

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1285549006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "512-318-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "512-318-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY WEIGHT LOSS MEDICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "BOUTTE",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "469-877-6278",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Victory Wound Care
• Vida Chiropractic, PLLC
• Vida Clinic PLLC
• Carla Vidal, MS, RD, LD
• Sophia Ivette Vidal

• Medical Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.