Healthcare Provider Details

I. General information

NPI: 1942741996
Provider Name (Legal Business Name): DR. MARCO A. VARGAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2017
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 SOUTHWEST FWY SUITE 130
SUGAR LAND TX
77478
US

IV. Provider business mailing address

15200 SOUTHWEST FWY SUITE 130
SUGAR LAND TX
77478-3845
US

V. Phone/Fax

Practice location:
  • Phone: 281-313-0090
  • Fax: 866-912-7672
Mailing address:
  • Phone: 281-313-0090
  • Fax: 866-912-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1504
License Number StateTX

VIII. Authorized Official

Name: MARCO VARGAS
Title or Position: OWNER/PROVIDER
Credential: MD
Phone: 281-313-0090