1215312517 NPI number — DR. ALISON VARGO PT DPT OCS FAAOMPT

Table of content: DR. ALISON VARGO PT DPT OCS FAAOMPT (NPI 1215312517)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215312517 NPI number — DR. ALISON VARGO PT DPT OCS FAAOMPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VARGO
Provider First Name:
ALISON
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PT DPT OCS FAAOMPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215312517
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5150 CRENSHAW RD
Provider Second Line Business Mailing Address:
SUITE D100
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77505-3094
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-943-1100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10371 STELLA LINK RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77025-5445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-974-2828
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1197201 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)