Individual provider Active NPI

Roland Paul Vargas, DDS

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1497799340
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16945 Issued in TX
Practice address
6750 Tezel Rd
Suite 108
San Antonio, TX 78250-4183
Phone
(210) 523-2345
Fax
(210) 680-1600
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16945 TX Primary

Addresses

Primary practice location

6750 Tezel Rd
Suite 108
San Antonio, TX 78250-4183

Mailing address

6750 Tezel Rd
Suite 108
San Antonio, TX 78250-4183
Phone (210) 523-2345

Other identifiers 1

IdentifierTypeStateIssuer
135056306MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16945TXMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1497799340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 TEZEL RD",
            "address_2": "SUITE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782504183",
            "telephone_number": "210-523-2345",
            "fax_number": "210-680-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 TEZEL RD",
            "address_2": "SUITE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782504183",
            "telephone_number": "210-523-2345",
            "fax_number": "210-680-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "ROLAND",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135056306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.