Provider Demographics
NPI:1467170993
Name:VARGAS, ELISABET (COTA, LMT)
Entity type:Individual
Prefix:
First Name:ELISABET
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:COTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 W SLAUGHTER LN APT 623
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6711
Mailing Address - Country:US
Mailing Address - Phone:817-808-2364
Mailing Address - Fax:
Practice Address - Street 1:1215 W SLAUGHTER LN APT 623
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6711
Practice Address - Country:US
Practice Address - Phone:817-808-2364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT107543225700000X
TX218087224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist