Provider Demographics
NPI:1184816225
Name:VARITEX
Entity Type:Organization
Organization Name:VARITEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:POMPHILE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-381-0266
Mailing Address - Street 1:2338 S BUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-8605
Mailing Address - Country:US
Mailing Address - Phone:214-381-0266
Mailing Address - Fax:214-381-2719
Practice Address - Street 1:2338 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-8605
Practice Address - Country:US
Practice Address - Phone:214-381-0266
Practice Address - Fax:214-381-2719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty