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NPI Code Detail

MEDICARE: MARISOL ADA VARGAS VILUGRON

MEDICARE: MARISOL ADA VARGAS VILUGRON
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
1104100000XSocial Worker
21041C0700XClinical Social Worker61868TX

General Provider Information

NPI Number : 1730501057
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISOL ADA VARGAS VILUGRON
Provider Business Mailing Address
First Line : 4001 WORTH ST
Second Line :
City : DALLAS
State : TX
Zip : 75246-1608
Country : US
Telephone Number : 214-828-1745
Fax Number : 214-352-0871
Provider Business Practice Location Address
First Line : 4001 WORTH ST
Second Line :
City : DALLAS
State : TX
Zip : 75246-1608
Country : US
Telephone Number : 214-828-1745
Fax Number : 214-352-0871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2014
Last Update Date : 12/16/2022

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Directions to “ MARISOL ADA VARGAS VILUGRON ” Practice Location

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