Healthcare Provider Details

I. General information

NPI: 1912844366
Provider Name (Legal Business Name): ROHAN VERGHESE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 FANNIN ST
HOUSTON TX
77030-3000
US

IV. Provider business mailing address

6410 FANNIN ST
HOUSTON TX
77030-3000
US

V. Phone/Fax

Practice location:
  • Phone: 832-325-6516
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberPA20576
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: