Provider Demographics
NPI:1538521851
Name:VARGAS, NELSON JR
Entity type:Individual
Prefix:MR
First Name:NELSON
Middle Name:
Last Name:VARGAS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 WILD PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3788
Mailing Address - Country:US
Mailing Address - Phone:254-535-2193
Mailing Address - Fax:
Practice Address - Street 1:819 WILD PRAIRIE DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3788
Practice Address - Country:US
Practice Address - Phone:254-535-2193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications