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NPI Code Detail

MEDICARE: LEOPOLD VILLEGAS III DO

MEDICARE: LEOPOLD VILLEGAS III DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianG7763TX

General Provider Information

NPI Number : 1003815093
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEOPOLD VILLEGAS III DO
Provider Business Mailing Address
First Line : 2548 MEMORIAL BLVD
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77640-2825
Country : US
Telephone Number : 409-983-1161
Fax Number : 409-983-4933
Provider Business Practice Location Address
First Line : 2548 MEMORIAL BLVD
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77640-2825
Country : US
Telephone Number : 409-983-1161
Fax Number : 409-983-4933
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 07/08/2007

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Directions to “ LEOPOLD VILLEGAS III DO” Practice Location

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