Provider Demographics
NPI:1962431262
Name:NOELIA VILLARREAL
Entity type:Organization
Organization Name:NOELIA VILLARREAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOELIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-544-8080
Mailing Address - Street 1:5235 SOUTHMOST RD STE D
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-8056
Mailing Address - Country:US
Mailing Address - Phone:956-544-8080
Mailing Address - Fax:956-544-8082
Practice Address - Street 1:5235 SOUTHMOST RD STE D
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-8056
Practice Address - Country:US
Practice Address - Phone:956-544-8080
Practice Address - Fax:956-544-8082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0056206332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4262030001Medicare NSC