Provider Demographics
NPI:1831913912
Name:VILLARREAL, JASMINE LIZETTE (RN)
Entity type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:LIZETTE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 SAN DELFINO ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-8232
Mailing Address - Country:US
Mailing Address - Phone:956-342-9194
Mailing Address - Fax:
Practice Address - Street 1:1002 SAN DELFINO ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-8232
Practice Address - Country:US
Practice Address - Phone:956-342-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1027526163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse