Organization
NOVA VITA WELLNESS CENTERS- WESTLAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEYTON THOMPSON (MEDICAL DIRECTOR)
(512) 460-7244
Entity
Organization
Contact information
Practice address
200 N LAKELINE BLVD STE C, CEDAR PARK, TX 78613-2090
(512) 387-5920
Mailing address
200 N LAKELINE BLVD STE C, CEDAR PARK, TX 78613-2090
(512) 387-5920
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
04/04/2023
Last updated
09/06/2023
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