New Vitality Clinic

LBN: New Vitality Clinic
New Vitality Clinic is an health care organization with primary practice located at 1207 N Virginia St , Port Lavaca TX 77979-2506. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. New Vitality Clinic can be contacted via phone (361) 746-1588, or through Gross, Gustavo Adolfo via phone (830) 491-2151.

Contact Information

Primary practice address
1207 N Virginia St Port Lavaca TX 77979-2506
Phone: (361) 746-1588
Fax: (361) 400-5310
Website:
Map and Directions
Authorized official contact:
Name: Gross, Gustavo Adolfo Doctor of Medicine (MD)
Phone: (830) 491-2151

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X Texas

Profile Details

NPI number 1285044057
LBN Legal business name New Vitality Clinic
DBA Doing business as
Authorized official Gross, Gustavo Adolfo Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2014
Last updated May 2nd, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285044057 NPPES
Texas Other 00886 STATE LIC NUMBER

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