MEDICARE: JENNIFER VARGAS LIC. AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC01766	TX

General Provider Information

NPI Number	:	1063926657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER VARGAS LIC. AC.

Provider Business Mailing Address
First Line	:	3330 AUDLEY ST STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1943
Country	:	US
Telephone Number	:	281-948-2951
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 AUDLEY ST STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1943
Country	:	US
Telephone Number	:	281-948-2951
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2017
Last Update Date	:	11/19/2017

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