Provider Demographics
NPI:1184820169
Name:VARGAS, CHRISTIAN M (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:M
Last Name:VARGAS
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SCHWEGLER DR
Mailing Address - Street 2:RM 2100
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66045-7538
Mailing Address - Country:US
Mailing Address - Phone:785-864-2277
Mailing Address - Fax:785-864-2721
Practice Address - Street 1:1200 SCHWEGLER DR
Practice Address - Street 2:RM 2100
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7538
Practice Address - Country:US
Practice Address - Phone:785-864-2277
Practice Address - Fax:785-864-2721
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS1099103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100117700AMedicaid