Provider Demographics
NPI:1982332409
Name:VILLARREAL, ANDREA ISABEL
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ISABEL
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HIDDEN VALLEY DR APT 17101
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1506
Mailing Address - Country:US
Mailing Address - Phone:210-396-0022
Mailing Address - Fax:
Practice Address - Street 1:1555 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8017
Practice Address - Country:US
Practice Address - Phone:512-716-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty