Provider Demographics
NPI:1629013974
Name:VILLARREAL, VICTOR ROMEO (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ROMEO
Last Name:VILLARREAL
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 1:3006 N RAUL LONGORIA RD
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3676
Mailing Address - Country:US
Mailing Address - Phone:956-283-9800
Mailing Address - Fax:956-283-7020
Practice Address - Street 1:3006 N RAUL LONGORIA RD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3676
Practice Address - Country:US
Practice Address - Phone:956-283-9800
Practice Address - Fax:956-283-7020
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1306380605Medicaid
TXB27336Medicare UPIN