Provider Demographics
NPI:1750443230
Name:VILLARREAL CANTU, LEONEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONEL
Middle Name:
Last Name:VILLARREAL CANTU
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 1:2727 W TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3433
Mailing Address - Country:US
Mailing Address - Phone:956-631-3999
Mailing Address - Fax:956-631-3983
Practice Address - Street 1:2727 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3433
Practice Address - Country:US
Practice Address - Phone:956-631-3999
Practice Address - Fax:956-631-3983
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5847207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF-93611Medicare UPIN
TX00379LMedicare ID - Type Unspecified