Provider Demographics
NPI:1447349493
Name:VILLARREAL, E LINDA (MD)
Entity type:Individual
Prefix:DR
First Name:E
Middle Name:LINDA
Last Name:VILLARREAL
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 1:1501 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5669
Mailing Address - Country:US
Mailing Address - Phone:956-381-5300
Mailing Address - Fax:956-316-4496
Practice Address - Street 1:1501 S. CLOSNER
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-381-5300
Practice Address - Fax:956-316-4496
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5498207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135173601Medicaid
TX88W041OtherBCBS GROUP & IND. #
TX084646101Medicaid
TX135582100OtherVALLEY HEALTH PLANS #
TX084646101Medicaid
TX88W041Medicare PIN
TX070002511Medicare PIN
TX135582100OtherVALLEY HEALTH PLANS #