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NPI Code Detail

MEDICARE: DOLLY SUSAN VARGHESE

MEDICARE: DOLLY SUSAN VARGHESE
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 PractitionerAP138714TX

General Provider Information

NPI Number : 1730746199
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOLLY SUSAN VARGHESE
Provider Business Mailing Address
First Line : 7709 SAN JACINTO PL STE 100
Second Line :
City : PLANO
State : TX
Zip : 75024-3369
Country : US
Telephone Number : 469-406-4245
Fax Number :
Provider Business Practice Location Address
First Line : 7709 SAN JACINTO PL STE 100
Second Line :
City : PLANO
State : TX
Zip : 75024-3369
Country : US
Telephone Number : 469-406-4245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2019
Last Update Date : 08/30/2023

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Directions to “ DOLLY SUSAN VARGHESE ” Practice Location

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