Provider Demographics
NPI:1457940868
Name:VARGAS, DEYSI (TECHNICIAN)
Entity Type:Individual
Prefix:MS
First Name:DEYSI
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:TECHNICIAN
Other - Prefix:MS
Other - First Name:DEYSI
Other - Middle Name:
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TECHNICIAN
Mailing Address - Street 1:23500 CIRCLE OAK PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2509
Mailing Address - Country:US
Mailing Address - Phone:281-239-3731
Mailing Address - Fax:
Practice Address - Street 1:23500 CIRCLE OAK PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2509
Practice Address - Country:US
Practice Address - Phone:281-239-3731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30138703183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician