Vitavia Telemedicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

VITAVIA TELEMEDICINE PLLC

Practice address

1301 W League City Pkwy
League City, TX 77573-6313

Phone

(445) 213-8818

Fax

(281) 994-7461

NPI assigned

Jan 28, 2021

Last updated

Dec 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Azfar Syed, MD

Title

Chief Executive Officer

Phone

(281) 900-4180

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1942891478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W LEAGUE CITY PKWY",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736313",
            "telephone_number": "281-900-4180",
            "fax_number": "281-994-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W LEAGUE CITY PKWY",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736313",
            "telephone_number": "445-213-8818",
            "fax_number": "281-994-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAVIA TELEMEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "AZFAR",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "281-900-4180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in League City, TX
• Providers in League City, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.