Provider Demographics
NPI:1407978448
Name:VILLARREAL, ANNIE R (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:R
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:PT
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 720157
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0157
Mailing Address - Country:US
Mailing Address - Phone:956-682-6900
Mailing Address - Fax:956-682-8445
Practice Address - Street 1:1002 W SAM HOUSTON
Practice Address - Street 2:SUITE 10
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5198
Practice Address - Country:US
Practice Address - Phone:956-702-9882
Practice Address - Fax:956-702-9886
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1135473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist