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NPI Code Detail

MEDICARE: VYTAL MOBILE HEALTH LLC

MEDICARE: VYTAL MOBILE HEALTH LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner

General Provider Information

NPI Number : 1780245134
Entity Type Code : Organization
Provider Name (Legal Business Name) : VYTAL MOBILE HEALTH LLC
Provider Business Mailing Address
First Line : 12501 PEBBLE VIEW DR
Second Line :
City : CONROE
State : TX
Zip : 77304-4233
Country : US
Telephone Number : 806-632-4819
Fax Number :
Provider Business Practice Location Address
First Line : 17350 STATE HIGHWAY 249 STE 222
Second Line :
City : HOUSTON
State : TX
Zip : 77064-1147
Country : US
Telephone Number : 936-444-2066
Fax Number :
Authorized Official
Title or Position : CEO
Name : GINGER BILLINGTON JENDRO
Credential : DNP, FNP-C, APRN
Telephone Number : 936-537-0315
Provider Enumeration Date : 06/26/2019
Last Update Date : 08/28/2023

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Directions to “VYTAL MOBILE HEALTH LLC ” Practice Location

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