Healthcare Provider Details

I. General information

NPI: 1558225441
Provider Name (Legal Business Name): AEVIA HEALTH & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 BRIARCREST DR STE 100A
BRYAN TX
77802-2500
US

IV. Provider business mailing address

1121 BRIARCREST DR STE 100A
BRYAN TX
77802-2500
US

V. Phone/Fax

Practice location:
  • Phone: 979-450-8781
  • Fax: 979-314-9002
Mailing address:
  • Phone: 979-450-8781
  • Fax: 979-314-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: REGINA VILLANUEVA ROBERTSON
Title or Position: OWNER
Credential: APRN, A-GNP-C
Phone: 979-450-8781