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NPI Code Detail

MEDICARE: VIRTUOUS HEALTH SERVICES, LLC

MEDICARE: VIRTUOUS HEALTH SERVICES, LLC
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
1291U00000XClinical Medical Laboratory
2251E00000XHome Health Agency

General Provider Information

NPI Number : 1326568650
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIRTUOUS HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 6960 REGATTA DR
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-7223
Country : US
Telephone Number : 817-405-6274
Fax Number : 817-779-7445
Provider Business Practice Location Address
First Line : 6960 REGATTA DR
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-7223
Country : US
Telephone Number : 817-405-6274
Fax Number : 817-779-7445
Authorized Official
Title or Position : CEO
Name : ENGGA MICKENS
Credential :
Telephone Number : 817-405-6274
Provider Enumeration Date : 06/27/2017
Last Update Date : 06/20/2026

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Directions to “VIRTUOUS HEALTH SERVICES, LLC ” Practice Location

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