Provider Demographics
NPI:1821784786
Name:VILLARREAL, STEPHANIE DANIELLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:DANIELLE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 CHRYSANTHEMUM
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-5198
Mailing Address - Country:US
Mailing Address - Phone:210-838-7556
Mailing Address - Fax:
Practice Address - Street 1:5460 BABCOCK RD STE 120-C
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3901
Practice Address - Country:US
Practice Address - Phone:210-753-0744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1115456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily