Provider Demographics
NPI:1346589710
Name:VARGHESE, ANUP KURIAN (RPH)
Entity Type:Individual
Prefix:
First Name:ANUP
Middle Name:KURIAN
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19251 PRESTON RD
Mailing Address - Street 2:APT#1108
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-8552
Mailing Address - Country:US
Mailing Address - Phone:248-275-5816
Mailing Address - Fax:
Practice Address - Street 1:19251 PRESTON RD
Practice Address - Street 2:APT # 1108
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-8552
Practice Address - Country:US
Practice Address - Phone:248-275-5816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51258183500000X
MI5302039206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist