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General NPI Number Information
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NPI Number | 1720874464
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Entity Type | Individual
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Provider Name | EDWIN ALBERTO VEGA VARGAS MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-695-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 21150 STAKED PLAINS DRIVE
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City | CYPRESS
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State | TX
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Zip | 77433
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Country | US
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Telephone | 281-684-4272
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | PENDING
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License Number State | NH
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