Individual
DR. SHAINY BENNY VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, RN, CPNP
Contact information
Practice address
2503 S MAIN ST, SUITE C, STAFFORD, TX 77477-5544
(281) 261-5800
(281) 261-5885
Mailing address
2503 S MAIN ST, SUITE C, STAFFORD, TX 77477-5544
(281) 261-5800
(281) 261-5885
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
603668
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
603668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962840074
NPI
TX
01
—
603668
STATE LICENSE
TX
Enumeration date
03/10/2010
Last updated
12/15/2022
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