Provider Demographics
NPI:1740806553
Name:VILLARREAL, ARMANDO DAVID (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:DAVID
Last Name:VILLARREAL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 N OAK STREET SUITE 220
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9465
Mailing Address - Country:US
Mailing Address - Phone:682-502-4440
Mailing Address - Fax:682-502-4490
Practice Address - Street 1:409 N OAK ST STE 220
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-6105
Practice Address - Country:US
Practice Address - Phone:682-502-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13309632251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic