Provider Demographics
NPI:1750696555
Name:ARNOLDO R. VILLARREAL, M. D., P.A.
Entity type:Organization
Organization Name:ARNOLDO R. VILLARREAL, M. D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:VELIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-882-4584
Mailing Address - Street 1:1521 S STAPLES ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3150
Mailing Address - Country:US
Mailing Address - Phone:361-882-4584
Mailing Address - Fax:361-882-5816
Practice Address - Street 1:1521 S STAPLES ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3150
Practice Address - Country:US
Practice Address - Phone:361-882-4584
Practice Address - Fax:361-882-5816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB27333Medicare UPIN