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General NPI Number Information
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NPI Number | 1750266169
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Entity Type | Organization
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Legal Business Name | VITAL WELLNESS
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 3140 LEGACY DR STE 310
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City | FRISCO
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State | TX
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Zip | 75034-9383
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Country | US
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Telephone | 833-284-8259
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Fax | 214-975-1593
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Provider Business Mailing Address
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Address Line | 8401 LINWOOD AVE
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City | DALLAS
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State | TX
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Zip | 75209-3217
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Country | US
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Telephone | 708-945-5974
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. LORETA PYTKA
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Credential | APRN
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Telephone | 708-945-5974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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