MEDICARE: DR. KOCHUPARAMPIL THOMAS VARGHESE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	G9240	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528075686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KOCHUPARAMPIL THOMAS VARGHESE MD

Provider Business Mailing Address
First Line	:	1704 N HAMPTON RD
Second Line	:	SUITE 204
City	:	DESOTO
State	:	TX
Zip	:	75115
Country	:	US
Telephone Number	:	972-224-7777
Fax Number	:	972-224-7779

Provider Business Practice Location Address
First Line	:	1704 N HAMPTON RD
Second Line	:	SUITE 204
City	:	DESOTO
State	:	TX
Zip	:	75115-8623
Country	:	US
Telephone Number	:	972-224-7777
Fax Number	:	972-224-7779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	11/21/2011

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