Provider Demographics
NPI:1720844467
Name:VENEGAS, DARSHA MARIE
Entity Type:Individual
Prefix:
First Name:DARSHA
Middle Name:MARIE
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:OK
Mailing Address - Zip Code:73086-1203
Mailing Address - Country:US
Mailing Address - Phone:580-277-5289
Mailing Address - Fax:
Practice Address - Street 1:1703 W 14TH ST
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:OK
Practice Address - Zip Code:73086-1203
Practice Address - Country:US
Practice Address - Phone:580-277-5289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator