Provider Demographics
NPI:1447730544
Name:VARGHESE, VARKEY M (OTR)
Entity type:Individual
Prefix:
First Name:VARKEY
Middle Name:M
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 ROCKPOINT CIR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7788
Mailing Address - Country:US
Mailing Address - Phone:832-964-7912
Mailing Address - Fax:
Practice Address - Street 1:17231 MILL FOREST RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4308
Practice Address - Country:US
Practice Address - Phone:281-488-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110075225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist