Provider Demographics
NPI:1851897060
Name:VILLAFRANCA, JAIME BRYAN (PA)
Entity Type:Individual
Prefix:MR
First Name:JAIME
Middle Name:BRYAN
Last Name:VILLAFRANCA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2440
Mailing Address - Fax:956-362-2448
Practice Address - Street 1:2821 MICHAELANGELO DR STE 306
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1418
Practice Address - Country:US
Practice Address - Phone:956-362-2440
Practice Address - Fax:956-362-2448
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11940363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA11940OtherPHYSICIAN ASSISTANT LICENSE