Provider Demographics
NPI:1508008285
Name:VILLARREAL, LUCILA MARGARITA (RD, LD)
Entity Type:Individual
Prefix:MS
First Name:LUCILA
Middle Name:MARGARITA
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 HOLLOW VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-2222
Mailing Address - Country:US
Mailing Address - Phone:210-493-1870
Mailing Address - Fax:210-493-1870
Practice Address - Street 1:730 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1152
Practice Address - Country:US
Practice Address - Phone:210-386-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT03632133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered