Provider Demographics
NPI:1922410950
Name:VARGAS-COBOS, LOURDES (NP)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:VARGAS-COBOS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11899 DAVID FORTI DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-2648
Mailing Address - Country:US
Mailing Address - Phone:915-857-3529
Mailing Address - Fax:
Practice Address - Street 1:12135 MONTWOOD DR STE 114-115
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4573
Practice Address - Country:US
Practice Address - Phone:915-225-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-26
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125654363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner