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General NPI Number Information
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NPI Number | 1487648622
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Entity Type | Individual
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Provider Name | JANIE VARGAS PA
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Gender | Female
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 300 S DIAMOND AVE
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City | DEMING
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State | NM
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Zip | 88030-3752
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Country | US
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Telephone | 575-546-4663
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Fax | 575-546-4844
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Provider Business Mailing Address
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Address Line | 300 S DIAMOND AVE
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City | DEMING
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State | NM
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Zip | 88030-3752
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Country | US
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Telephone | 575-546-4663
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Fax | 505-443-8331
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA2004-0009
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2004-0009
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License Number State | NM
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