Provider Demographics
NPI:1356551873
Name:VARGAS-LAGUNAS, MIGUEL ANGEL (MD)
Entity type:Individual
Prefix:MR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:VARGAS-LAGUNAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2465 REYNOLDS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7296
Mailing Address - Country:US
Mailing Address - Phone:702-476-9600
Mailing Address - Fax:702-476-8972
Practice Address - Street 1:2465 REYNOLDS AVE STE 101
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7296
Practice Address - Country:US
Practice Address - Phone:702-476-9600
Practice Address - Fax:702-476-8972
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12464207R00000X, 193400000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No193400000XGroupSingle Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1356551873Medicaid
NVV108104OtherMEDICARE PTAN
NVV108104OtherMEDICARE PTAN
NVBR001XMedicare PIN