Provider Demographics
NPI:1558470773
Name:VITAL HEALTH CARE INC.
Entity Type:Organization
Organization Name:VITAL HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:956-782-0002
Mailing Address - Street 1:1703 W OWASSA RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-7047
Mailing Address - Country:US
Mailing Address - Phone:956-782-0002
Mailing Address - Fax:956-702-3222
Practice Address - Street 1:1703 W OWASSA RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-7047
Practice Address - Country:US
Practice Address - Phone:956-782-0002
Practice Address - Fax:956-702-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677787104100000X, 163W00000X, 163WH0200X, 163WW0000X, 164X00000X, 225100000X, 225X00000X, 235Z00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Not Answered163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
Not Answered164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX003230Medicaid
TX003230Medicaid