Organization
VITAL PHYSICIAN SERVICES PLLC
Active
Other names
Evolution Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DANIEL HANNAH PA-C (OWNER)
(737) 222-5553
Entity
Organization
Contact information
Practice address
3720 GATTIS SCHOOL RD STE 800, ROUND ROCK, TX 78664-4660
(808) 646-1691
Mailing address
3720 GATTIS SCHOOL RD STE 800, ROUND ROCK, TX 78664-4660
(737) 222-5553
(833) 907-2248
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/14/2021
Last updated
12/22/2021
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