Provider Demographics
NPI:1568889319
Name:VARGAS, RICARDO (NP)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:
Last Name:VARGAS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7430 REMCON CIR
Mailing Address - Street 2:BLDG A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3514
Mailing Address - Country:US
Mailing Address - Phone:915-584-0051
Mailing Address - Fax:915-833-1114
Practice Address - Street 1:7430 REMCON CIR
Practice Address - Street 2:BLDG A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3514
Practice Address - Country:US
Practice Address - Phone:915-584-0051
Practice Address - Fax:915-833-1114
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP125444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX345316YLPSOtherWELLMED PTAN
TX338045301Medicaid