Provider Demographics
NPI:1427891076
Name:VILLEGAS, PAULINO III
Entity type:Individual
Prefix:
First Name:PAULINO
Middle Name:
Last Name:VILLEGAS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 AVE UNIVERSIDAD
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925
Mailing Address - Country:US
Mailing Address - Phone:956-639-2631
Mailing Address - Fax:
Practice Address - Street 1:6156 PIPERS WALK
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-2226
Practice Address - Country:US
Practice Address - Phone:956-639-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program