Organization
SIXTO G. VARGAS
Active
Other names
Century M Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIXTO G VARGAS JR. CO, LO (OWNER)
(361) 852-0614
Entity
Organization
Contact information
Practice address
4949 EVERHART RD, SUITE 104B, CORPUS CHRISTI, TX 78411-3949
(361) 852-0614
(361) 852-0046
Mailing address
PO BOX 6942, CORPUS CHRISTI, TX 78466-6942
(361) 852-0614
(361) 852-0046
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
470
TX
335E00000X
Prosthetic/Orthotic Supplier
Primary
470
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150380701
—
TX
01
—
150380702
MEDICAID HOME HEALTH
TX
01
—
531013
BCBS
TX
Enumeration date
02/05/2008
Last updated
06/21/2018
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