Provider Demographics
NPI:1053665323
Name:GEORGETA VARGA MD PARKINSON DISEASE MOVEMENT DISORDERS CLINIC PLLC
Entity Type:Organization
Organization Name:GEORGETA VARGA MD PARKINSON DISEASE MOVEMENT DISORDERS CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:GEORGETA
Authorized Official - Last Name:VARGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-900-2477
Mailing Address - Street 1:PO BOX 11824
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4009
Mailing Address - Country:US
Mailing Address - Phone:512-900-2477
Mailing Address - Fax:512-900-2478
Practice Address - Street 1:3001 BEE CAVE RD STE 210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5590
Practice Address - Country:US
Practice Address - Phone:512-900-2477
Practice Address - Fax:512-900-2478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0090YGOtherBCBS OF TEXAS
TX263167YL9KMedicare PIN