Provider Demographics
NPI:1841002813
Name:VARGAS, JOSE G (CPHT)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:G
Last Name:VARGAS
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
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Mailing Address - Street 1:1107 PAMELA DR STE B
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4340
Mailing Address - Country:US
Mailing Address - Phone:956-529-1150
Mailing Address - Fax:956-683-6152
Practice Address - Street 1:1107 PAMELA DR STE B
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4340
Practice Address - Country:US
Practice Address - Phone:956-529-1150
Practice Address - Fax:956-683-6152
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX258238183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician