Healthcare Provider Details

I. General information

NPI: 1104793611
Provider Name (Legal Business Name): KAREN HAM VARGAS LPC
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12406 DUTCH HARBOR LN
HUMBLE TX
77346-3691
US

IV. Provider business mailing address

12406 DUTCH HARBOR LN
HUMBLE TX
77346-3691
US

V. Phone/Fax

Practice location:
  • Phone: 832-723-5772
  • Fax:
Mailing address:
  • Phone: 832-723-5772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number91459
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: