Provider Demographics
NPI:1104826114
Name:VILLAREAL, KARA (MD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:
Last Name:VILLAREAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 E BELL RD
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2122
Mailing Address - Country:US
Mailing Address - Phone:602-995-0822
Mailing Address - Fax:602-995-0825
Practice Address - Street 1:3815 E BELL RD
Practice Address - Street 2:SUITE 2200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2122
Practice Address - Country:US
Practice Address - Phone:602-995-0822
Practice Address - Fax:602-995-0825
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27026208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH62538Medicare UPIN