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NPI Code Detail

MEDICARE: DEBRA BORJON VILLA

MEDICARE: DEBRA BORJON VILLA
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
1164X00000XLicensed Vocational Nurse333010TX

General Provider Information

NPI Number : 1043799521
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA BORJON VILLA
Provider Business Mailing Address
First Line : 11502 FORT SMITH
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-3691
Country : US
Telephone Number : 707-330-9155
Fax Number :
Provider Business Practice Location Address
First Line : 11502 FORT SMITH
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-3691
Country : US
Telephone Number : 707-330-9155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2018
Last Update Date : 08/07/2018

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Directions to “ DEBRA BORJON VILLA ” Practice Location

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