Healthcare Provider Details

I. General information

NPI: 1073073615
Provider Name (Legal Business Name): PEDRO A VILLARREAL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PEDRO ARTURO VILLARREAL LCSW

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 TREASURE HILLS BLVD
HARLINGEN TX
78550-8736
US

IV. Provider business mailing address

2106 TREASURE HILLS BLVD
HARLINGEN TX
78550-8736
US

V. Phone/Fax

Practice location:
  • Phone: 956-366-4500
  • Fax:
Mailing address:
  • Phone: 956-366-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number56417
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: