Provider Demographics
NPI:1851168082
Name:VILLARREAL, BECKY
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N LOOP 336 E
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1437
Mailing Address - Country:US
Mailing Address - Phone:281-742-1142
Mailing Address - Fax:346-998-1442
Practice Address - Street 1:610 N LOOP 336 E
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1437
Practice Address - Country:US
Practice Address - Phone:281-742-1142
Practice Address - Fax:346-998-1442
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX379791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical