=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437437332
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORBERTO VARGAS MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2011
-----------------------------------------------------
Last Update Date | 07/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3201 E PRESIDENT GEORGE BUSH HWY SUITE 107
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75082-3566
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-691-2975
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3201 E PRESIDENT GEORGE BUSH HWY SUITE 107
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75082-3566
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/PHYSICIAN
-----------------------------------------------------
Name | DR. NORBERTO VARGAS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 214-641-0296
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 273Y00000X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Hospital Unit
-----------------------------------------------------
License Number | L6694
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 283X00000X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Hospital
-----------------------------------------------------
License Number | L6694
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 313M00000X
-----------------------------------------------------
Taxonomy Name | Nursing Facility/Intermediate Care Facility
-----------------------------------------------------
License Number | L6694
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------