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General NPI Number Information
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NPI Number | 1891962072
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Entity Type | Organization
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Legal Business Name | TED C. VARGAS, INC.
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 319 N 1ST ST
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City | PACIFIC
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State | MO
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Zip | 63069-1505
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Country | US
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Telephone | 636-271-3500
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Fax | 636-271-9955
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Provider Business Mailing Address
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Address Line | 319 N 1ST ST
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City | PACIFIC
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State | MO
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Zip | 63069-1505
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Country | US
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Telephone | 636-271-3500
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Fax | 636-271-9955
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TEODORO C. VARGAS
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Credential | M.D.
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Telephone | 636-271-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34914
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License Number State | MO
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