| Vitals Family Medicine Pllc | |
|
1420 W Exchange Pkwy Ste 120 Allen TX 75013-4696 | |
| (972) 521-6210 | |
| Not Available |
| Full Name | Vitals Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1420 W Exchange Pkwy Ste 120, Allen, Texas |
| Authorized Official Name and Position | Roopam Shyam (OWNER) |
| Authorized Official Contact | 9725216210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitals Family Medicine Pllc 2317 High Country Way Plano TX 75025-4781 Ph: (972) 521-6210 | Vitals Family Medicine Pllc 1420 W Exchange Pkwy Ste 120 Allen TX 75013-4696 Ph: (972) 521-6210 |
| NPI Number | 1174046452 |
|---|---|
| Provider Enumeration Date | 07/19/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9830463983 |
|---|---|
| Medicare Enrollment ID | O20170928000134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174046452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M6396 (Texas) | Primary |
| Provider Name | Roopam Shyam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417152182 PECOS PAC ID: 0749368611 Enrollment ID: I20080417000057 |
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