Provider Demographics
NPI:1699190975
Name:VILLARREAL MEDICAL CENTER, PA
Entity Type:Organization
Organization Name:VILLARREAL MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:ROMEO
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-283-9800
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0342261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care