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General NPI Number Information
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NPI Number | 1770469207
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Entity Type | Organization
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Legal Business Name | VITALHEALTH-PROSPER LLC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1400 N COIT RD STE 1903
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City | MCKINNEY
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State | TX
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Zip | 75071-6661
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Country | US
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Telephone | 469-481-6274
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Fax | 469-481-6274
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Provider Business Mailing Address
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Address Line | 6225 PAINSWICK DR
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City | AUBREY
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State | TX
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Zip | 76227-2928
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Country | US
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Telephone | 469-481-6274
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Fax | 469-481-6274
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Authorized Official
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Title or Position | OWNER
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Name | TEJIRI OJARUEGA
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Credential | NP
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Telephone | 469-481-6274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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