Provider Demographics
NPI:1194210518
Name:VARGAS, BETHANY G (DO)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:G
Last Name:VARGAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-363-3600
Mailing Address - Fax:
Practice Address - Street 1:411 10TH ST SE STE 150
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2449
Practice Address - Country:US
Practice Address - Phone:319-363-3600
Practice Address - Fax:319-678-7399
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT1872208000000X
IADO-06378208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics