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General NPI Number Information
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NPI Number | 1952192668
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Entity Type | Organization
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Legal Business Name | VITALITY HEALTH AND WELLNESS MEDSPA
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 2922 S HIGHWAY 205
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City | ROCKWALL
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State | TX
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Zip | 75032-2610
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Country | US
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Telephone | 903-274-2748
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Fax |
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Provider Business Mailing Address
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Address Line | 2922 S HIGHWAY 205
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City | ROCKWALL
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State | TX
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Zip | 75032-2610
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Country | US
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Telephone | 903-274-2748
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TONI LEI HENRY
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Credential | FNP-BC
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Telephone | 903-274-2748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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