Provider Demographics
NPI:1265818579
Name:VARGAS MD PC
Entity Type:Organization
Organization Name:VARGAS MD PC
Other - Org Name:SANTA FE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:VARGAS LAGUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:702-218-1142
Mailing Address - Street 1:2828 E LAKE MEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6550
Mailing Address - Country:US
Mailing Address - Phone:702-480-0377
Mailing Address - Fax:702-224-2104
Practice Address - Street 1:2828 E LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6550
Practice Address - Country:US
Practice Address - Phone:702-480-0377
Practice Address - Fax:702-224-2104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANTA FE MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-10
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12464261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care