Provider Demographics
NPI:1770198616
Name:VILLARREAL, KATHERINE LEANG (CPNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LEANG
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:CPNP
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Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-922-7000
Mailing Address - Fax:210-227-0282
Practice Address - Street 1:315 N SAN SABA STE 1075
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3155
Practice Address - Country:US
Practice Address - Phone:210-223-3543
Practice Address - Fax:210-227-0282
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1010494363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics