Provider Demographics
NPI:1306822598
Name:VILLARREAL, MARGARET ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 650865
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0865
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:
Practice Address - Street 1:13737 NOEL ROAD
Practice Address - Street 2:SUITE 1400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-2004
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX644157367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161038805Medicaid
TX161038806OtherMEDICAID CSHCN
OK200394100AMedicaid
TXP00957382OtherRAILROAD
TX85325UOtherBCBS
TX161038803Medicaid
P88865Medicare UPIN
OK200394100AMedicaid
TXTXB118440Medicare PIN