Provider Demographics
NPI:1922796440
Name:VARPON, MIATTA
Entity Type:Individual
Prefix:
First Name:MIATTA
Middle Name:
Last Name:VARPON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18202 THICKET GROVE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7598
Mailing Address - Country:US
Mailing Address - Phone:281-896-2012
Mailing Address - Fax:
Practice Address - Street 1:18202 THICKET GROVE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7598
Practice Address - Country:US
Practice Address - Phone:281-896-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-21-164588106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician