Provider Demographics
NPI:1740864628
Name:VILLARREAL, XIMENA (FNP)
Entity type:Individual
Prefix:
First Name:XIMENA
Middle Name:
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 ROSS OSAGE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79103
Mailing Address - Country:US
Mailing Address - Phone:806-350-5790
Mailing Address - Fax:806-350-5791
Practice Address - Street 1:2329 ROSS OSAGE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103
Practice Address - Country:US
Practice Address - Phone:806-350-5790
Practice Address - Fax:806-350-5791
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP1024507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1024507OtherLICENSE NUMBER