OrganizationVitality Weight Loss And Wellness Institute, PllcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address2633 Dallas Pkwy # 100, Plano, TX 75093-4703(972) 737-3296PECOS EnrollmentBased on the most recent information from CMS, provider Vitality Weight Loss And Wellness Institute, Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1821543208Provider TypeOrganizationFull NameVitality Weight Loss And Wellness Institute, PllcSubpartNoEnumeration Date8/16/2016Last Updated8/16/2016Contact InformationPractice LocationPractice Address2633 Dallas Pkwy # 100, Plano, TX 75093-4703Phone(972) 737-3296FaxUnlisted FaxMailing LocationMailing Address5760 Legacy Dr Ste B3-424, Plano, TX 75024-7102Phone(972) 737-3296FaxUnlisted FaxAuthorized OfficialNameShah, Ruby Jain (Member Manager)Phone(951) 314-2930Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseQ6034Texas