Provider Demographics
NPI:1174949267
Name:VARUGHESE GEORGE, DEEPU (PHD)
Entity type:Individual
Prefix:
First Name:DEEPU
Middle Name:
Last Name:VARUGHESE GEORGE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 MICHAEL ANGELO
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-1404
Mailing Address - Country:US
Mailing Address - Phone:956-362-6520
Mailing Address - Fax:956-362-3529
Practice Address - Street 1:3804 S JACKSON RD STE 2
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6683
Practice Address - Country:US
Practice Address - Phone:956-296-3021
Practice Address - Fax:956-296-3020
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9070A106H00000X
TX202397106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9070AOtherLICENSED MARRIAGE AND FAMILY THERAPY ASSOCIATE
TX202397OtherTX STATE BOARD OF EXAMINERS OF MARRIAGE AND FAMILY THERAPISTS - LMFT-A