Provider Demographics
NPI:1750842886
Name:VILLARREAL, ARNULFO JR (RD, LD)
Entity Type:Individual
Prefix:MR
First Name:ARNULFO
Middle Name:
Last Name:VILLARREAL
Suffix:JR
Gender:M
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 CLIFF MAUS DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78416-2533
Mailing Address - Country:US
Mailing Address - Phone:361-537-9271
Mailing Address - Fax:
Practice Address - Street 1:1809 CLIFF MAUS DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78416-2533
Practice Address - Country:US
Practice Address - Phone:361-537-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80245133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered