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Organization
VITAL HEALTH LLP
Active
Organization
VITAL HEALTH LLP
Active
Other names
Carlos R Villalta, MD Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS R VILLALTA MD (OWNER)
(210) 742-7300
Entity
Organization
Contact information
Practice address
32685 US HIGHWAY 281 N STE 120, BULVERDE, TX 78163-3272
(210) 742-7300
(210) 742-7301
Mailing address
PO BOX 1632, MISSION, TX 78573-0029
(956) 584-3231
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151603101
—
TX
Enumeration date
07/01/2008
Last updated
06/26/2019
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