Provider Demographics
NPI:1790522134
Name:VARGAS, ANTHONY DANIEL (LVN)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:DANIEL
Last Name:VARGAS
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 CRESTWAY RD LOT 236
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-2871
Mailing Address - Country:US
Mailing Address - Phone:210-518-6368
Mailing Address - Fax:
Practice Address - Street 1:6435 CRESTWAY RD LOT 236
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-2871
Practice Address - Country:US
Practice Address - Phone:210-518-6368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1153042164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse