Provider Demographics
NPI:1376200576
Name:VILLARREAL-LEAL, JACQUELINE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:VILLARREAL-LEAL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6511 ENCORE OAKS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-1851
Mailing Address - Country:US
Mailing Address - Phone:210-372-7549
Mailing Address - Fax:
Practice Address - Street 1:6511 ENCORE OAKS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78252-1851
Practice Address - Country:US
Practice Address - Phone:210-372-7549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059229363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics