Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 623 | MN |
N | 213ES0103X | Foot & Ankle Surgery | 807 | WI |
NPI | 1023014784 |
---|---|
Provider Name | Dr. Troy Allen Vargas |
First Address | Oak Park Heights, MN 55082-2177 |
Second Address | Oak Park Heights, MN 55082-2177 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 30/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U77308 | (02) |