Provider Demographics
NPI:1841447869
Name:VARGAS, VICENTE JR (RT(R))
Entity type:Individual
Prefix:MR
First Name:VICENTE
Middle Name:
Last Name:VARGAS
Suffix:JR
Gender:M
Credentials:RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-1307
Mailing Address - Country:US
Mailing Address - Phone:915-565-2742
Mailing Address - Fax:
Practice Address - Street 1:3920 CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-1307
Practice Address - Country:US
Practice Address - Phone:915-565-2742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX335935247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist