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NPI Code Detail

MEDICARE: MARY LEVILLE VARGAS

MEDICARE:   MARY LEVILLE  VARGAS
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
1363L00000XNurse Practitioner1229401TX

General Provider Information

NPI Number : 1235087222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LEVILLE VARGAS
Provider Business Mailing Address
First Line : 10258 WHITNEY REACH DR
Second Line :
City : ROSHARON
State : TX
Zip : 77583-1777
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10258 WHITNEY REACH DR
Second Line :
City : ROSHARON
State : TX
Zip : 77583-1777
Country : US
Telephone Number : 210-859-6501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ MARY LEVILLE VARGAS ” Practice Location

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