Provider Demographics
NPI:1780245134
Name:VYTAL MOBILE HEALTH LLC
Entity type:Organization
Organization Name:VYTAL MOBILE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:BILLINGTON
Authorized Official - Last Name:JENDRO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C, APRN
Authorized Official - Phone:936-537-0315
Mailing Address - Street 1:12501 PEBBLE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-4233
Mailing Address - Country:US
Mailing Address - Phone:806-632-4819
Mailing Address - Fax:
Practice Address - Street 1:17350 STATE HIGHWAY 249 STE 222
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-1147
Practice Address - Country:US
Practice Address - Phone:936-444-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty