Provider Demographics
NPI:1023241247
Name:VILLA, PAOLA JANETH (OTR)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:JANETH
Last Name:VILLA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N INTERNATIONAL BLVD STE 101-1606
Mailing Address - Street 2:
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-2582
Mailing Address - Country:US
Mailing Address - Phone:956-600-2919
Mailing Address - Fax:956-232-3856
Practice Address - Street 1:1001 S 10TH ST STE 3060
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2278
Practice Address - Country:US
Practice Address - Phone:956-600-2919
Practice Address - Fax:956-232-3856
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113264225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist