Provider Demographics
NPI:1538538038
Name:VARGHESE, REEJA (FNP)
Entity type:Individual
Prefix:
First Name:REEJA
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 LINCOLNSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5902
Mailing Address - Country:US
Mailing Address - Phone:214-493-2877
Mailing Address - Fax:
Practice Address - Street 1:13737 NOEL RD STE 1600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-1374
Practice Address - Country:US
Practice Address - Phone:469-518-4823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily