Provider Demographics
NPI:1871134254
Name:VILLARREAL, ALFREDO (RN)
Entity type:Individual
Prefix:
First Name:ALFREDO
Middle Name:
Last Name:VILLARREAL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 W HIGHWAY 83
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584
Mailing Address - Country:US
Mailing Address - Phone:956-519-3227
Mailing Address - Fax:
Practice Address - Street 1:4902 W HIGHWAY 83
Practice Address - Street 2:SUITE 2
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584
Practice Address - Country:US
Practice Address - Phone:956-519-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX736537163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health