Provider Demographics
NPI:1295276095
Name:DR MARCO A VARGAS PA
Entity type:Organization
Organization Name:DR MARCO A VARGAS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-313-0090
Mailing Address - Street 1:15200 SOUTHWEST FWY STE 130
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3863
Mailing Address - Country:US
Mailing Address - Phone:281-313-0090
Mailing Address - Fax:866-912-7672
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:SUITE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:281-313-0090
Practice Address - Fax:866-912-7672
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR MARCO A VARGAS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-13
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1267745225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty