MEDICARE: PRISCILLA VARGAS-PEREZ

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1104506146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA VARGAS-PEREZ

Provider Business Mailing Address
First Line	:	12601 N PENNSYLVANIA AVE APT 342
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-9410
Country	:	US
Telephone Number	:	620-309-0452
Fax Number	:

Provider Business Practice Location Address
First Line	:	12601 N PENNSYLVANIA AVE APT 342
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-9410
Country	:	US
Telephone Number	:	620-309-0452
Fax Number	:

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

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	07/24/2023

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Directions to “ PRISCILLA VARGAS-PEREZ ” Practice Location

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