Provider Demographics
NPI:1184946329
Name:VILLALUNA, ANAIS ANGELICA (SLP)
Entity type:Individual
Prefix:
First Name:ANAIS
Middle Name:ANGELICA
Last Name:VILLALUNA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26400 KUYKENDAHL RD STE C180-405
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2882
Mailing Address - Country:US
Mailing Address - Phone:713-820-0441
Mailing Address - Fax:936-286-6463
Practice Address - Street 1:26400 KUYKENDAHL RD STE C180-405
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77375-2882
Practice Address - Country:US
Practice Address - Phone:713-635-9462
Practice Address - Fax:936-286-6463
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104315235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149984001Medicaid
TX676535Medicare PIN
TX456606Medicare PIN