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General NPI Number Information
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NPI Number | 1962226662
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Entity Type | Individual
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Provider Name | ALEXIS KALEIHIILANI VILLA
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 3507 JAIME ZAPATA MEMORIAL HWY STE 5
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City | LAREDO
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State | TX
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Zip | 78043-4770
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Country | US
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Telephone | 956-726-9252
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Fax |
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Provider Business Mailing Address
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Address Line | 146 NIAGARA DR
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City | LAREDO
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State | TX
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Zip | 78045-7433
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Country | US
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Telephone | 808-953-7820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1179703
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License Number State | TX
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