MEDICARE: PATRICIO T VILLARREAL MD

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
1	207P00000X	Emergency Medicine Physician	J0336	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0083GG	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1033199542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIO T VILLARREAL MD

Provider Business Mailing Address
First Line	:	2310 E HIGHWAY 97
Second Line	:
City	:	PLEASANTON
State	:	TX
Zip	:	78064-6516
Country	:	US
Telephone Number	:	830-281-2868
Fax Number	:	830-281-8521

Provider Business Practice Location Address
First Line	:	1905 HIGHWAY 97 E
Second Line	:	EMERGENCY ROOM
City	:	JOURDANTON
State	:	TX
Zip	:	78026-1504
Country	:	US
Telephone Number	:	830-769-5204
Fax Number	:	830-769-5206

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	03/10/2011

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Directions to “ PATRICIO T VILLARREAL MD” Practice Location

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