Provider Demographics
NPI:1396848529
Name:ARMANDO VILLARREAL MD PA
Entity type:Organization
Organization Name:ARMANDO VILLARREAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-569-6340
Mailing Address - Street 1:1540 W GOODWIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-3804
Mailing Address - Country:US
Mailing Address - Phone:830-569-6340
Mailing Address - Fax:
Practice Address - Street 1:1540 W GOODWIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-3804
Practice Address - Country:US
Practice Address - Phone:830-569-6340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX063660701Medicaid
TX458965OtherMEDICARE
TXX0054580OtherDPS
TXX0054580OtherDPS
TXB227335Medicare UPIN
TX458965Medicare Oscar/Certification