Provider Demographics
NPI:1831531888
Name:VILLARREAL, VALERIE (MOT OTR)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:MOT OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 LOMAS DEL SUR STE 114
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-5751
Mailing Address - Country:US
Mailing Address - Phone:956-729-7555
Mailing Address - Fax:956-729-7886
Practice Address - Street 1:2110 LOMAS DEL SUR STE 114
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-5751
Practice Address - Country:US
Practice Address - Phone:956-729-7555
Practice Address - Fax:956-729-7886
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115511225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115511OtherOCCUPATIONAL THERAPIST