Healthcare Provider Details

I. General information

NPI: 1952013831
Provider Name (Legal Business Name): MR. JOSUE GIOVANI VILLARREAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

IV. Provider business mailing address

8206 LOUISIANA BLVD NE STE A
ALBUQUERQUE NM
87113-1738
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-5666
  • Fax: 915-215-5047
Mailing address:
  • Phone: 917-996-9493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number70824
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number316208
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1127914
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number70824
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: