Provider Demographics
NPI:1275710055
Name:ROBERTO VILLEGAS, JR., M.D. NEONATOLOGY, P.A.
Entity Type:Organization
Organization Name:ROBERTO VILLEGAS, JR., M.D. NEONATOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLEGAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:956-791-5429
Mailing Address - Street 1:2320 MIDDLECOFF LN
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8159
Mailing Address - Country:US
Mailing Address - Phone:956-791-5429
Mailing Address - Fax:
Practice Address - Street 1:10710 MCPHERSON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6271
Practice Address - Country:US
Practice Address - Phone:956-795-1440
Practice Address - Fax:956-795-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL59422080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty