Provider Demographics
NPI:1912151440
Name:VARGAS, RAUL HUMBERTO (DC)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:HUMBERTO
Last Name:VARGAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 N FRY RD STE 190
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-8670
Mailing Address - Country:US
Mailing Address - Phone:281-829-3577
Mailing Address - Fax:281-829-3574
Practice Address - Street 1:3111 FRY RD STE 170
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6742
Practice Address - Country:US
Practice Address - Phone:281-829-3577
Practice Address - Fax:281-829-3574
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10991111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor