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General NPI Number Information
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NPI Number | 1245214998
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Entity Type | Organization
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Legal Business Name | SUPERIOR FAMILY CLINIC, P.A.
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 6930 SPRINGFIELD AVE SUITE 2
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City | LAREDO
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State | TX
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Zip | 78041-2312
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Country | US
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Telephone | 956-753-3901
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Fax | 956-753-3434
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Provider Business Mailing Address
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Address Line | 4619 SAN DARIO AVE #310
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City | LAREDO
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State | TX
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Zip | 78041-5773
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Country | US
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Telephone | 956-753-3901
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Fax | 956-753-3434
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Authorized Official
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Title or Position | M.D.
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Name | DR. LUIS FEDERICO VILLARREAL
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Credential | M.D.
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Telephone | 956-721-4451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L8549
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License Number State | TX
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