Organization
VITALITY CLINICS OF EAST TEXAS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN KIP YODER M.D. (OWNER)
(903) 525-9432
Entity
Organization
Contact information
Practice address
455 RICE RD, 102, TYLER, TX 75703-3604
(903) 525-9432
(903) 525-9455
Mailing address
455 RICE RD, 102, TYLER, TX 75703-3604
(903) 525-9432
(903) 525-9455
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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