Provider Demographics
NPI:1053750331
Name:VARUGHESE, LIBU (MD)
Entity type:Individual
Prefix:DR
First Name:LIBU
Middle Name:
Last Name:VARUGHESE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 HIGHWAY 6 STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4951
Mailing Address - Country:US
Mailing Address - Phone:832-968-7003
Mailing Address - Fax:832-968-7713
Practice Address - Street 1:1441 HIGHWAY 6 STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4951
Practice Address - Country:US
Practice Address - Phone:832-968-7003
Practice Address - Fax:832-968-7713
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.138459207RE0101X
TXR4915207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR4915OtherTEXAS MEDICAL LICENSE