Provider Demographics
NPI:1144395336
Name:VARGAS, OSCAR A (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:A
Last Name:VARGAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 CHELSEA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903
Mailing Address - Country:US
Mailing Address - Phone:915-779-5553
Mailing Address - Fax:915-779-2566
Practice Address - Street 1:811 CHELSEA
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903
Practice Address - Country:US
Practice Address - Phone:915-779-5553
Practice Address - Fax:915-779-2566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX153741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX091042401Medicaid