Provider Demographics
NPI:1174504575
Name:VILLARREAL, RACHEL DIANE (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:DIANE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5563
Mailing Address - Country:US
Mailing Address - Phone:956-607-4825
Mailing Address - Fax:
Practice Address - Street 1:5525 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5563
Practice Address - Country:US
Practice Address - Phone:956-607-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-11
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06987133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered