Provider Demographics
NPI:1437846177
Name:VARGAS, ERICA MARINA (PA-C)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:MARINA
Last Name:VARGAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:MARINA
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MLS
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:800-994-0371
Mailing Address - Fax:254-215-9722
Practice Address - Street 1:7451 W STATE HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-6849
Practice Address - Country:US
Practice Address - Phone:512-509-8700
Practice Address - Fax:512-509-8701
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant