Provider Demographics
NPI:1669720926
Name:VARGHESE, SHAUN SAM (MD)
Entity type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:SAM
Last Name:VARGHESE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:920 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3260
Mailing Address - Country:US
Mailing Address - Phone:281-298-1144
Mailing Address - Fax:281-298-1133
Practice Address - Street 1:920 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3260
Practice Address - Country:US
Practice Address - Phone:281-298-1144
Practice Address - Fax:281-298-1133
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2015-05-22
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Provider Licenses
StateLicense IDTaxonomies
TXP97602084N0402X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology