MEDICARE: ROBERTO VILLEGAS JR. 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	208000000X	Pediatrics Physician	L5942	TX
2	2080N0001X	Neonatal-Perinatal Medicine Physician	L5942	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265546287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTO VILLEGAS JR. MD

Provider Business Mailing Address
First Line	:	2320 MIDDLECOFF LN
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-8159
Country	:	US
Telephone Number	:	956-795-1440
Fax Number	:	956-795-0092

Provider Business Practice Location Address
First Line	:	10710 MCPHERSON RD
Second Line	:	SUITE 204
City	:	LAREDO
State	:	TX
Zip	:	78045-6271
Country	:	US
Telephone Number	:	956-795-1440
Fax Number	:	956-795-0092

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	05/29/2015

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