Provider Demographics
NPI:1467827865
Name:VARGHESE, JIJA (MSN,RN,FNP-C)
Entity Type:Individual
Prefix:
First Name:JIJA
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:MSN,RN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 EMMETT F LOWRY EXPY STE C
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2001
Mailing Address - Country:US
Mailing Address - Phone:409-949-3406
Mailing Address - Fax:409-949-3492
Practice Address - Street 1:9850-C EMMETT F.LOWRY EXPY
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591
Practice Address - Country:US
Practice Address - Phone:409-949-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily