Provider Demographics
NPI:1134724560
Name:VARGHESE, KURIAN
Entity type:Individual
Prefix:
First Name:KURIAN
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 RIMINA WAY DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5203
Mailing Address - Country:US
Mailing Address - Phone:586-381-3949
Mailing Address - Fax:
Practice Address - Street 1:6750 READING RD
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2390
Practice Address - Country:US
Practice Address - Phone:281-239-3899
Practice Address - Fax:281-547-7336
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist