MEDICARE: ANDREW VARGAS PA-C

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	363AM0700X	Medical Physician Assistant	PA02278	TX

General Provider Information

NPI Number	:	1619970191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW VARGAS PA-C

Provider Business Mailing Address
First Line	:	3315 BURKE RD
Second Line	:	STE 202
City	:	PASADENA
State	:	TX
Zip	:	77504-1823
Country	:	US
Telephone Number	:	713-946-9513
Fax Number	:	713-946-7210

Provider Business Practice Location Address
First Line	:	3315 BURKE RD
Second Line	:	STE 202
City	:	PASADENA
State	:	TX
Zip	:	77504-1823
Country	:	US
Telephone Number	:	713-946-9513
Fax Number	:	713-946-7210

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/09/2007

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