Provider Demographics
NPI:1730310376
Name:VILLARREAL, AARON KATHRYN (PA-C)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:KATHRYN
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 BROADWAY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1004
Mailing Address - Country:US
Mailing Address - Phone:210-595-1019
Mailing Address - Fax:210-251-3194
Practice Address - Street 1:2520 BROADWAY ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1004
Practice Address - Country:US
Practice Address - Phone:210-595-1019
Practice Address - Fax:210-251-3194
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06034363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical