Provider Demographics
NPI:1417966854
Name:VILLANUEVA, GIL RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:GIL
Middle Name:RAYMOND
Last Name:VILLANUEVA
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 1:1162 E SONTERRA BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4048
Mailing Address - Country:US
Mailing Address - Phone:210-494-8100
Mailing Address - Fax:210-494-8106
Practice Address - Street 1:1162 E SONTERRA BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4048
Practice Address - Country:US
Practice Address - Phone:210-494-8100
Practice Address - Fax:210-494-8106
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0334207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037946301Medicaid
TXF83494Medicare UPIN
TX80M127Medicare ID - Type Unspecified