Provider Demographics
NPI:1093925778
Name:DEVILLENA, CHANTAL BARLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANTAL
Middle Name:BARLAND
Last Name:DEVILLENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHANTAL
Other - Middle Name:O'CONNOR
Other - Last Name:BARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18540 SIGMA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4274
Mailing Address - Country:US
Mailing Address - Phone:210-490-4661
Mailing Address - Fax:210-490-4661
Practice Address - Street 1:18540 SIGMA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4274
Practice Address - Country:US
Practice Address - Phone:210-490-4661
Practice Address - Fax:210-490-4661
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9144207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology