Healthcare Provider Details

I. General information

NPI: 1922862127
Provider Name (Legal Business Name): VITALITY HEALTH PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13359 N HIGHWAY 183 STE 403
AUSTIN TX
78750-7154
US

IV. Provider business mailing address

3515 LONGMIRE DR STE B120
COLLEGE STATION TX
77845-5489
US

V. Phone/Fax

Practice location:
  • Phone: 512-867-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHAROLETTE OBRINGER
Title or Position: MANAGER
Credential:
Phone: 708-567-8633