Provider Demographics
NPI:1881218329
Name:VILLARREAL, VICTORIA G (AUD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:G
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 BEE CAVES RD STE A102
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6458
Mailing Address - Country:US
Mailing Address - Phone:512-704-7447
Mailing Address - Fax:
Practice Address - Street 1:4201 BEE CAVES RD STE A102
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6458
Practice Address - Country:US
Practice Address - Phone:512-704-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81166231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist