=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144020751
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE VARA PSYCHOTHERAPY GROUP, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2025
-----------------------------------------------------
Last Update Date | 03/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19221 INTERSTATE 45 S STE 110-18
-----------------------------------------------------
City | SHENANDOAH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77385-8756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-237-8272
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 102 MAHOGANY ST
-----------------------------------------------------
City | SHENANDOAH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77384-4382
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-948-0362
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & CEO
-----------------------------------------------------
Name | MR. FELIX VARA
-----------------------------------------------------
Credential | LMFT ASSOCIATE
-----------------------------------------------------
Telephone | 402-237-8272
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------