| Ellen Vital Solution LLC | |
|
9711 S Mason Rd Ste 125-650 Richmond TX 77407-7167 | |
| (281) 941-2887 | |
| (281) 816-1001 |
| Full Name | Ellen Vital Solution LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9711 S Mason Rd Ste 125-650, Richmond, Texas |
| Authorized Official Name and Position | Ebere Opara (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 3463130150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Vital Solution LLC 9711 S Mason Rd Ste 125-650 Richmond TX 77407-7167 Ph: (281) 941-2887 | Ellen Vital Solution LLC 9711 S Mason Rd Ste 125-650 Richmond TX 77407-7167 Ph: (281) 941-2887 |
| NPI Number | 1487229472 |
|---|---|
| Provider Enumeration Date | 05/24/2021 |
| Last Update Date | 11/05/2021 |
| Certification Date | 11/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487229472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
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