Provider Demographics
NPI:1710954342
Name:VARGHESE, BLESSY ELIZABETH (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:BLESSY
Middle Name:ELIZABETH
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:BLESSY
Other - Middle Name:ELIZABETH
Other - Last Name:KURIAKOSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:2317 WEST UNIVERSITY DR
Mailing Address - Street 2:SUITE A-7
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201
Mailing Address - Country:US
Mailing Address - Phone:940-349-0024
Mailing Address - Fax:940-349-0027
Practice Address - Street 1:2317 WEST UNIVERSITY DR
Practice Address - Street 2:SUITE A-7
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-349-0024
Practice Address - Fax:940-349-0027
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1154880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
456844Medicare ID - Type Unspecified