MEDICARE: VITAL HOUSECALL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1386332898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL HOUSECALL LLC

Provider Business Mailing Address
First Line	:	515 WADE CT
Second Line	:
City	:	EULESS
State	:	TX
Zip	:	76039-2085
Country	:	US
Telephone Number	:	214-777-2703
Fax Number	:	817-865-1530

Provider Business Practice Location Address
First Line	:	1221 W AIRPORT FWY STE 209 UNIT B
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-6209
Country	:	US
Telephone Number	:	214-777-2703
Fax Number	:	817-865-1530

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NAUREEN SALIM
Credential	:
Telephone Number	:	214-777-2703

Provider Enumeration Date	:	04/25/2023
Last Update Date	:	03/25/2026

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Directions to “VITAL HOUSECALL LLC ” Practice Location

Language	Start Address	Practice Location

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