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NPI Code Detail

MEDICARE: VITALHEALTH-PROSPER LLC

MEDICARE: VITALHEALTH-PROSPER 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
1363LG0600XGerontology Nurse Practitioner

General Provider Information

NPI Number : 1770469207
Entity Type Code : Organization
Provider Name (Legal Business Name) : VITALHEALTH-PROSPER LLC
Provider Business Mailing Address
First Line : 6225 PAINSWICK DR
Second Line :
City : AUBREY
State : TX
Zip : 76227-2928
Country : US
Telephone Number : 469-481-6274
Fax Number : 469-481-6274
Provider Business Practice Location Address
First Line : 1400 N COIT RD STE 1903
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-6661
Country : US
Telephone Number : 469-481-6274
Fax Number : 469-481-6274
Authorized Official
Title or Position : OWNER
Name : TEJIRI OJARUEGA
Credential : NP
Telephone Number : 469-481-6274
Provider Enumeration Date : 08/12/2025
Last Update Date : 08/12/2025

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Directions to “VITALHEALTH-PROSPER LLC ” Practice Location

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