MEDICARE: EVELYN VARGAS

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1922679588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN VARGAS

Provider Business Mailing Address
First Line	:	3700 PECOS MCLEOD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4259
Country	:	US
Telephone Number	:	702-816-3400
Fax Number	:	702-816-3403

Provider Business Practice Location Address
First Line	:	3700 PECOS MCLEOD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4259
Country	:	US
Telephone Number	:	702-816-3400
Fax Number	:	702-816-3403

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

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	07/06/2021

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Directions to “ EVELYN VARGAS ” Practice Location

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