MEDICARE: VITALIS MEDICAL CENTER

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	364SF0001X	Family Health Clinical Nurse Specialist
2	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1912841776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITALIS MEDICAL CENTER

Provider Business Mailing Address
First Line	:	20514 WESTFIELD ESTATES DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-4720
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20514 WESTFIELD ESTATES DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-4720
Country	:	US
Telephone Number	:	786-942-0500
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	LAZARO ALEXANDER YERO ZAMORA
Credential	:	APRN
Telephone Number	:	786-942-0500

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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