Provider Demographics
NPI:1366622938
Name:VILLEGAS, MARIA DE LA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA DE LA LUZ
Middle Name:
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 TREASURE HILLS BLVD # 3.14406
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8736
Mailing Address - Country:US
Mailing Address - Phone:956-296-1437
Mailing Address - Fax:956-296-6842
Practice Address - Street 1:615 CAMELOT DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8472
Practice Address - Country:US
Practice Address - Phone:956-296-2701
Practice Address - Fax:956-296-2700
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7019207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4097222-01Medicaid
TXH08MQ14001OtherBCBS