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General NPI Number Information
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NPI Number | 1336676923
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Entity Type | Organization
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Legal Business Name | VILLAGEMD INDIANA, PC
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 6097 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-2619
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Country | US
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Telephone | 888-975-1055
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Fax | 713-647-0307
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Provider Business Mailing Address
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Address Line | 4650 WESTWAY PARK BLVD STE 206
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City | HOUSTON
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State | TX
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Zip | 77041-2006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR REVENUE CYCLE
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Name | REBECCA RAGER
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Credential |
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Telephone | 832-257-6915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 01078373A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 01078373A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01078373A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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