Organization Active NPI

Vital Wellness & Weight Loss P.a.

  • Obesity Medicine (Family Medicine) Physician
  • Dallas, TX
National Provider Identifier
1295155273
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
License
H6104 Issued in TX
Legal business name
VITAL WELLNESS & WEIGHT LOSS P.A.
Practice address
18800 Preston Rd
Suite 310
Dallas, TX 75252-2449
Phone
(972) 985-5511
NPI assigned
Apr 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Michele W Cavenee, M.D.NPI 1184869794
Title
Co-Owner
Phone
(214) 769-2398

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
Obesity Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QB0002X H6104 TX Primary

Addresses

Primary practice location

18800 Preston Rd
Suite 310
Dallas, TX 75252-2449

Mailing address

5128 Corinthian Bay Dr
Plano, TX 75093-4001

National Provider Directory

National Provider Directory

Locations

18800 Preston Rd
Ste 310
Dallas, TX 75252
Phone (214) 619-5225

Practitioners & affiliated clinicians

Practitioners 3

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": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1295155273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5128 CORINTHIAN BAY DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 PRESTON RD",
            "address_2": "SUITE 310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752522449",
            "telephone_number": "972-985-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL WELLNESS & WEIGHT LOSS P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "CAVENEE",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "214-769-2398",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "TX",
            "license": "H6104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.