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General NPI Number Information
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NPI Number | 1346881463
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Entity Type | Individual
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Provider Name | VICTOR VARGHESE PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 905 N GULF BLVD
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City | FREEPORT
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State | TX
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Zip | 77541-3907
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Country | US
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Telephone | 281-824-1480
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Fax | 281-220-6407
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Provider Business Mailing Address
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Address Line | 1111 W ADOUE ST
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City | ALVIN
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State | TX
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Zip | 77511-2718
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Country | US
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Telephone | 281-824-1480
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Fax | 281-220-6407
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP142983
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP142983
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License Number State | TX
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