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General NPI Number Information
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NPI Number | 1629785936
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Entity Type | Organization
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Legal Business Name | CLINICA VILLANUEVA FAMILY PRACTICE PLLC
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 1795 S VETERANS BLVD
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City | EAGLE PASS
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State | TX
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Zip | 78852-6746
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Country | US
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Telephone | 210-627-1983
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Fax | 833-464-4427
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Provider Business Mailing Address
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Address Line | 1795 S VETERANS BLVD
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City | EAGLE PASS
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State | TX
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Zip | 78852-6746
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Country | US
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Telephone | 830-421-5057
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Fax | 833-464-4427
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Authorized Official
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Title or Position | FNP
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Name | MRS. ANA GUARDIOLA
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Credential |
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Telephone | 830-421-5057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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