MEDICARE: FRANCISCO JAVIER VILLA COUNSELOR

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	2376-A	TX

General Provider Information

NPI Number	:	1851455190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCISCO JAVIER VILLA COUNSELOR

Provider Business Mailing Address
First Line	:	1280 HAWKINS BLVD
Second Line	:	SUITE 202
City	:	EL PASO
State	:	TX
Zip	:	79925-4957
Country	:	US
Telephone Number	:	915-599-0090
Fax Number	:	915-590-8090

Provider Business Practice Location Address
First Line	:	8201 LOCKHEED DR
Second Line	:	STE 115
City	:	EL PASO
State	:	TX
Zip	:	79925-2500
Country	:	US
Telephone Number	:	915-775-9891
Fax Number	:

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	07/08/2007

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