Provider Demographics
NPI:1760582647
Name:VARGAS, MARCO A (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:A
Last Name:VARGAS
Suffix:
Gender:M
Credentials:DPM
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17510 W GRAND PARKWAY SOUTH
Mailing Address - Street 2:SUITE 530 - APPOINTMENTS ONLY
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3244
Mailing Address - Country:US
Mailing Address - Phone:281-313-0090
Mailing Address - Fax:866-912-7672
Practice Address - Street 1:17510 W GRAND PARKWAY SOUTH -APPOINTMENTS ONLY-
Practice Address - Street 2:SUITE 530
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3244
Practice Address - Country:US
Practice Address - Phone:281-342-8700
Practice Address - Fax:281-232-7918
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1504213EP1101X
TXBV6387890213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU75643Medicare UPIN
TX00919EMedicare ID - Type Unspecified