Provider Demographics
NPI:1801987730
Name:VARGAS, MARCO A (PA-C)
Entity type:Individual
Prefix:MR
First Name:MARCO
Middle Name:A
Last Name:VARGAS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 E NOLANA AVE STE 13A
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6112
Mailing Address - Country:US
Mailing Address - Phone:956-686-2700
Mailing Address - Fax:956-686-2708
Practice Address - Street 1:801 E NOLANA AVE STE 13A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6112
Practice Address - Country:US
Practice Address - Phone:956-686-2700
Practice Address - Fax:956-686-2708
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01447363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0805541-01Medicaid
TX8L1512OtherMEDICARE