Healthcare Provider Details

I. General information

NPI: 1396766838
Provider Name (Legal Business Name): JAIME VILLARREAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 11/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 LINDBERG AVE
MCALLEN TX
78501-2920
US

IV. Provider business mailing address

PO BOX 4449
MCALLEN TX
78502-4449
US

V. Phone/Fax

Practice location:
  • Phone: 956-971-0066
  • Fax: 956-362-0072
Mailing address:
  • Phone: 956-971-0066
  • Fax: 956-971-0072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberH0907
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: