MEDICARE: DR. JAVIER G. VILLANUEVA PH.D.

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	103T00000X	Psychologist	2598	CO
2	103T00000X	Psychologist	31920	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

General Provider Information

NPI Number	:	1144226457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAVIER G. VILLANUEVA PH.D.

Provider Business Mailing Address
First Line	:	7618 BRISTON PARK DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-4714
Country	:	US
Telephone Number	:	210-849-1244
Fax Number	:	210-615-1767

Provider Business Practice Location Address
First Line	:	7410 JOHN SMITH
Second Line	:	STE 214
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-6000
Country	:	US
Telephone Number	:	210-849-1244
Fax Number	:	210-691-0111

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	05/09/2025

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Directions to “ DR. JAVIER G. VILLANUEVA PH.D.” Practice Location

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