Provider Demographics
NPI:1285682674
Name:VILLALOBOS, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:VILLALOBOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 S SOLANO DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5402
Mailing Address - Country:US
Mailing Address - Phone:505-521-1158
Mailing Address - Fax:505-521-1007
Practice Address - Street 1:2030 S SOLANO DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5402
Practice Address - Country:US
Practice Address - Phone:505-521-1158
Practice Address - Fax:505-521-1007
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM83137207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM002878OtherBCBS NM
NMCN4173OtherRR MEDICARE
NM000S8425Medicaid
NM$$$$$$$$$Medicare PIN
NMNM002878OtherBCBS NM