Provider Demographics
NPI:1194229674
Name:VILLARREAL, YOLANDA JUDITH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:JUDITH
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13725 NORTHWEST BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-5123
Mailing Address - Country:US
Mailing Address - Phone:361-387-0005
Mailing Address - Fax:361-387-1132
Practice Address - Street 1:13725 NORTHWEST BLVD STE 130
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5123
Practice Address - Country:US
Practice Address - Phone:361-387-0005
Practice Address - Fax:361-387-1132
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist