Provider Demographics
NPI:1639112170
Name:VARUGHESE, ANNIE T (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:T
Last Name:VARUGHESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133007
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-3007
Mailing Address - Country:US
Mailing Address - Phone:281-866-7701
Mailing Address - Fax:281-866-7705
Practice Address - Street 1:1011 MEDICAL PLAZA DR STE 130
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3248
Practice Address - Country:US
Practice Address - Phone:281-866-7701
Practice Address - Fax:281-866-7705
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8408207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A9462Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
TXG14071Medicare UPIN