Provider Demographics
NPI:1841876034
Name:VILLAFRANCA, AMANDA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:VILLAFRANCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 WEST BUSINESS 77
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-8096
Mailing Address - Country:US
Mailing Address - Phone:956-399-5233
Mailing Address - Fax:956-399-5046
Practice Address - Street 1:1095 WEST BUSINESS 77
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-8096
Practice Address - Country:US
Practice Address - Phone:956-399-5233
Practice Address - Fax:956-399-5046
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39599390200000X
TX72895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program