Provider Demographics
NPI:1831139708
Name:VILLAFANI, MARIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:
Last Name:VILLAFANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:275 LANTERN BEND DR
Mailing Address - Street 2:STE. 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2831
Mailing Address - Country:US
Mailing Address - Phone:281-440-0101
Mailing Address - Fax:281-440-6441
Practice Address - Street 1:275 LANTERN BEND DR
Practice Address - Street 2:STE. 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2831
Practice Address - Country:US
Practice Address - Phone:281-440-0101
Practice Address - Fax:281-440-6441
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG0926207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U8362OtherBLUE CROSS PROV. NUMBER