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MR. VARUGHESE MAX BABY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
4314 YOAKUM BLVD, HOUSTON, TX 77006-5818
(713) 850-0049
(713) 850-0036
Mailing address
3430 HIDDEN CREEK DR, SUGAR LAND, TX 77479-1651
(516) 749-3845

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
781646
TX
390200000X
Student in an Organized Health Care Education/Training Program
525591
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
215863601
TX
05
215863602
TX
05
215863603
TX
05
215863604
TX
05
215863605
TX
01
834N18
BCBS TX
TX
01
847N28
BCBS TX
TX
01
859N32
BCBS TX
TX
01
P00889009
RAIL ROAD MEDICARE
TX
01
P00967678
RAIL ROAD MCR DALLAS
TX
Enumeration date
09/29/2008
Last updated
07/02/2012
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