Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vine Family Medicine PLLC

Organization Family Medicine Physician · NPI 1407427420

Vine Family Medicine PLLC is a Family Medicine Physician in Keller, Texas. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

420 Johnson Rd Ste 304
Keller, TX 76248-3463
Phone: (817) 710-3040
Fax: (989) 200-4650
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1407427420
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ochuele Odumosu — Medical Director · (817) 710-3040
NPI enumeratedJuly 9, 2021
Last updated in NPPESJuly 12, 2021
Certification dateJuly 12, 2021
Mailing address420 Johnson Rd Ste 304, Keller, TX 76248-3463

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