Provider Demographics
NPI:1811923824
Name:VILLASENOR, JOSH
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:VILLASENOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOSUE
Other - Middle Name:
Other - Last Name:VILLASENOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUDIO PROSTHOLOGIST
Mailing Address - Street 1:1562 WESTBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-1838
Mailing Address - Country:US
Mailing Address - Phone:432-254-1251
Mailing Address - Fax:432-296-6605
Practice Address - Street 1:7001 GATEWAY BOULEVARD
Practice Address - Street 2:LIBERTY HEARING AID CENTER
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925
Practice Address - Country:US
Practice Address - Phone:915-771-7896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50120237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist