Provider Demographics
NPI:1114130598
Name:VILLARREAL, MARCUS SALVADOR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:SALVADOR
Last Name:VILLARREAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8205 STRECKER LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-4351
Mailing Address - Country:US
Mailing Address - Phone:972-712-1660
Mailing Address - Fax:208-275-4451
Practice Address - Street 1:8205 STRECKER LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-4351
Practice Address - Country:US
Practice Address - Phone:972-712-1660
Practice Address - Fax:208-275-4451
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0240207PH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine