Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 07875R | LA |
Y | 2080P0205X | Pediatric Endocrinologist | 07875R | LA |
NPI | 1114949971 |
---|---|
Provider Name | Alfonso Vargas |
First Address | New Orleans, LA 70118-5720 |
Second Address | New Orleans, LA 70118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 03/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01773500 | (05) | NY |
03052563 | (05) | MS |
1384992 | (05) | LA |
D82505 | (02) |