Healthcare Provider Details

I. General information

NPI: 1053665323
Provider Name (Legal Business Name): GEORGETA VARGA MD PARKINSON DISEASE MOVEMENT DISORDERS CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 BEE CAVE RD STE 210
AUSTIN TX
78746-5590
US

IV. Provider business mailing address

PO BOX 11824
BELFAST ME
04915-4009
US

V. Phone/Fax

Practice location:
  • Phone: 512-900-2477
  • Fax: 512-900-2478
Mailing address:
  • Phone: 512-900-2477
  • Fax: 512-900-2478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIANA GEORGETA VARGA
Title or Position: PRESIDENT
Credential: MD
Phone: 512-900-2477