Provider Demographics
NPI:1972527208
Name:VARGAS, SIXTO VIII (CO, LO, BOCO)
Entity Type:Individual
Prefix:PROF
First Name:SIXTO
Middle Name:
Last Name:VARGAS
Suffix:VIII
Gender:M
Credentials:CO, LO, BOCO
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 6942
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6942
Mailing Address - Country:US
Mailing Address - Phone:361-852-0614
Mailing Address - Fax:361-852-0046
Practice Address - Street 1:5718 MCARDLE RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-3455
Practice Address - Country:US
Practice Address - Phone:361-852-0614
Practice Address - Fax:361-852-0046
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX470222Z00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531013OtherBCBS OF TEXAS
TX4281320001Medicare NSC