Basic Information
Provider Information
NPI: 1194165415
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VARUGHESE
FirstName: JOSEPH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 26222 RANCH ROAD 12
Address2:  
City: DRIPPING SPRINGS
State: TX
PostalCode: 786204903
CountryCode: US
TelephoneNumber: 5128580300
FaxNumber: 5128582714
Practice Location
Address1: 1708 W 24TH ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770081410
CountryCode: US
TelephoneNumber: 7138694700
FaxNumber: 7138693578
Other Information
ProviderEnumerationDate: 07/01/2013
LastUpdateDate: 07/01/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X80497TXY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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