Provider Demographics
NPI:1821161712
Name:VARGAS- GREEN, ADRIANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:VARGAS- GREEN
Suffix:
Gender:F
Credentials:DDS
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 40397
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3900
Mailing Address - Country:US
Mailing Address - Phone:210-567-6405
Mailing Address - Fax:210-567-2844
Practice Address - Street 1:8210 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3923
Practice Address - Country:US
Practice Address - Phone:210-450-3273
Practice Address - Fax:210-450-2223
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF21691122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
88D813OtherBLUE CROSS BLUE SHIELD
8C2026Medicare ID - Type Unspecified
I16037Medicare UPIN