Provider Demographics
NPI:1942484530
Name:VARGHESE, BETSY PUTHENBENGLAVIL (FNP-C)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:PUTHENBENGLAVIL
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 BOONE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1659
Mailing Address - Country:US
Mailing Address - Phone:281-454-0500
Mailing Address - Fax:281-454-0516
Practice Address - Street 1:8901 BOONE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1659
Practice Address - Country:US
Practice Address - Phone:281-454-0500
Practice Address - Fax:281-454-0516
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190415304Medicaid
TX190415301Medicaid