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Individual

MOBIN T VARGHESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3604 LIVE OAK ST STE 100, DALLAS, TX 75204-6169
(214) 358-2300
(214) 366-6331
Mailing address
1420 VICEROY DR, DALLAS, TX 75235-2208
(214) 358-2300
(214) 366-6331

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1020382
TX
363LF0000X
Family Nurse Practitioner
1020382
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1020382
TX LICENSE
TX
Enumeration date
03/25/2021
Last updated
02/24/2022
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