Provider Demographics
NPI:1669248845
Name:QUIET VISTA HEALTHCARE LLC
Entity type:Organization
Organization Name:QUIET VISTA HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-643-8292
Mailing Address - Street 1:4655 SWEETWATER BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3147
Mailing Address - Country:US
Mailing Address - Phone:281-643-8292
Mailing Address - Fax:833-999-4620
Practice Address - Street 1:4655 SWEETWATER BLVD STE 650
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3147
Practice Address - Country:US
Practice Address - Phone:281-643-8292
Practice Address - Fax:833-999-4620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty