# VITAL HEALTH LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carlos R Villalta, MD Pediatric Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548422439
- **Authorized official:** CARLOS R VILLALTA MD (OWNER)
- **Authorized official phone:** (210) 742-7300

## Contact information

- **Practice address:** 32685 US HIGHWAY 281 N STE 120, BULVERDE, TX 78163-3272
- **Practice address phone:** (210) 742-7300
- **Practice address fax:** (210) 742-7301
- **Mailing address:** PO BOX 1632, MISSION, TX 78573-0029
- **Mailing address phone:** (956) 584-3231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2008
- **Last updated:** 06/26/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 151603101 | — | TX |