Provider Demographics
NPI:1508220427
Name:VILLAMOR, ANTONIO NATHAN III (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:NATHAN
Last Name:VILLAMOR
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-0101
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:
Practice Address - Street 1:10970 SHADOW CREEK PKWY STE 270
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0121
Practice Address - Country:US
Practice Address - Phone:832-220-3018
Practice Address - Fax:833-954-3894
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXU3048208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery