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NPI Code Detail

MEDICARE: JADE VILLAREAL

MEDICARE: JADE VILLAREAL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1144941089
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE VILLAREAL
Provider Business Mailing Address
First Line : 3737 EXECUTIVE CENTER DR STE 255
Second Line :
City : AUSTIN
State : TX
Zip : 78731-1633
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3737 EXECUTIVE CENTER DR STE 255
Second Line :
City : AUSTIN
State : TX
Zip : 78731-1633
Country : US
Telephone Number : 512-340-0171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2022
Last Update Date : 07/24/2025

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Directions to “ JADE VILLAREAL ” Practice Location

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