Healthcare Provider Details

I. General information

NPI: 1619997319
Provider Name (Legal Business Name): RAMON G. VILLAFRIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N FREDONIA ST
LONGVIEW TX
75601-6464
US

IV. Provider business mailing address

1107 E MARSHALL AVE
LONGVIEW TX
75601-5602
US

V. Phone/Fax

Practice location:
  • Phone: 903-758-2610
  • Fax: 903-758-7081
Mailing address:
  • Phone: 903-758-2610
  • Fax: 903-758-7081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN9418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: