Provider Demographics
NPI:1871203588
Name:VARGAS, VIRGINIA (LMT)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 QUALIA DR
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-7750
Mailing Address - Country:US
Mailing Address - Phone:830-765-8721
Mailing Address - Fax:
Practice Address - Street 1:900B QUALIA DR
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-7750
Practice Address - Country:US
Practice Address - Phone:830-765-8721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT119325225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist