Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 35.138459 | OH |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | R4915 | TX |
NPI | 1053750331 |
---|---|
Provider Name | Dr. Libu Varughese |
First Address | Houston, TX 77081-5360 |
Second Address | Houston, TX 77081-5360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2013 |
Last Update Date | 25/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R4915 | TEXAS MEDICAL LICENSE (01) | TX |