Provider Demographics
NPI:1215184999
Name:VILLARREAL, PAULA DEGLEY (OTR)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:DEGLEY
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:PAULA
Other - Middle Name:D
Other - Last Name:VILLARREAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:5405 REMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552
Mailing Address - Country:US
Mailing Address - Phone:956-501-7175
Mailing Address - Fax:
Practice Address - Street 1:2904 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1870
Practice Address - Country:US
Practice Address - Phone:956-631-8646
Practice Address - Fax:956-631-8650
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111706225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T7189OtherBCBS