Individual
JENNIFER VARISTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1651 ROCK PRAIRIE RD, SUITE 102, COLLEGE STATION, TX 77845-8652
(979) 693-7400
(979) 693-7446
Mailing address
1500 UNIVERSITY DR E STE 100, COLLEGE STATION, TX 77840-2600
(979) 846-1100
(979) 260-9390
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
P8822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275726853
FACILITY NPI
TX
01
—
1878423-01
FACILITY TPI
TX
01
—
67-1861
MEDICARE FACILITY NUMBER
TX
Enumeration date
07/30/2012
Last updated
09/08/2014
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