Provider Demographics
NPI:1699424754
Name:VILLARREAL, LOUIS DANIEL
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:DANIEL
Last Name:VILLARREAL
Suffix:
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 1:3520 BROADWAY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4307
Mailing Address - Country:US
Mailing Address - Phone:281-686-1289
Mailing Address - Fax:
Practice Address - Street 1:3520 BROADWAY ST STE 102
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4307
Practice Address - Country:US
Practice Address - Phone:281-686-1289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty