MEDICARE: GERALD VILLAREAL LEVY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	H7586	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00698904	OTHER	TX	MEDICARE RAILROAD
6	060069465	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8BX077	OTHER	TX	BCBSTX
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154306306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD VILLAREAL LEVY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1509
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78295-1509
Country	:	US
Telephone Number	:	512-623-5300
Fax Number	:	512-623-5399

Provider Business Practice Location Address
First Line	:	4316 JAMES CASEY ST
Second Line	:	BUILDING C
City	:	AUSTIN
State	:	TX
Zip	:	78745-1157
Country	:	US
Telephone Number	:	512-623-5300
Fax Number	:	512-623-5399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	06/24/2011

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