Provider Demographics
NPI:1588944920
Name:VILLARREAL-LEVY, CHRISTINE CAROLINE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CAROLINE
Last Name:VILLARREAL-LEVY
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 1:2909 N IH 35
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722-2304
Mailing Address - Country:US
Mailing Address - Phone:512-478-4939
Mailing Address - Fax:512-320-0702
Practice Address - Street 1:2909 N IH 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78722-2304
Practice Address - Country:US
Practice Address - Phone:512-478-4939
Practice Address - Fax:512-320-0702
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2399208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics