Provider Demographics
NPI:1558958322
Name:VILLALOBOS, ALEXANDRIA LAUREN (BSN, RN, CCRN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:LAUREN
Last Name:VILLALOBOS
Suffix:
Gender:F
Credentials:BSN, RN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14603 HUEBNER RD
Mailing Address - Street 2:BLDG. 28 STE. 28101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5497
Mailing Address - Country:US
Mailing Address - Phone:210-614-7074
Mailing Address - Fax:
Practice Address - Street 1:14603 HUEBNER RD.
Practice Address - Street 2:BLDG. 28 STE. 28101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230
Practice Address - Country:US
Practice Address - Phone:210-614-7074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX881840163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse