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NPI Code Detail

MEDICARE: ZAIRA ANGELICA LUCERO VILLA MD

MEDICARE: ZAIRA ANGELICA LUCERO VILLA 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
1207Q00000XFamily Medicine PhysicianV6631TX
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1235860560
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZAIRA ANGELICA LUCERO VILLA MD
Provider Business Mailing Address
First Line : 4121 SAN ANTONIO ST APT 1418
Second Line :
City : ODESSA
State : TX
Zip : 79765-2495
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 W 4TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-5001
Country : US
Telephone Number : 999-999-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2022
Last Update Date : 01/27/2026

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Directions to “ ZAIRA ANGELICA LUCERO VILLA MD” Practice Location

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