Organization
VITAE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY ANDREW KALAMARIDES DO (PHYSICIAN/MEDICAL DIRECTOR)
(512) 458-6060
Entity
Organization
Contact information
Practice address
1600 W 38TH ST, SUITE 115, AUSTIN, TX 78731-6400
(512) 458-6060
(512) 458-6070
Mailing address
PO BOX 301990, 3507 N. LAMAR, AUSTIN, TX 78703-0034
(512) 458-6060
(512) 458-6070
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217737001
—
TX
Enumeration date
08/12/2010
Last updated
01/05/2012
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