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General NPI Number Information
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NPI Number | 1811876881
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Entity Type | Individual
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Provider Name | JAISON VARGHESE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 4050 W MEMORIAL RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-8382
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Country | US
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Telephone | 405-608-1404
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Fax | 405-972-7590
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Provider Business Mailing Address
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Address Line | 4050 W MEMORIAL RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-8358
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Country | US
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Telephone | 405-608-1404
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Fax | 405-972-7590
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13841
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License Number State | OK
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