Provider Demographics
NPI:1215016480
Name:VILLASENOR, HECTOR RAUL (MD)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:RAUL
Last Name:VILLASENOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:215 E QUINCY ST STE 427
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-2033
Mailing Address - Country:US
Mailing Address - Phone:210-223-7500
Mailing Address - Fax:210-223-9075
Practice Address - Street 1:215 E QUINCY ST STE 427
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2033
Practice Address - Country:US
Practice Address - Phone:210-223-7500
Practice Address - Fax:210-223-9075
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF3371207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152401901Medicaid
TX137198106Medicaid
TX88T011OtherBCBS
B27339Medicare UPIN
TX137198106Medicaid