MEDICARE: DIANA XIMENA LARRAIN VILLALPANDO 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	2080P0214X	Pediatric Pulmonology Physician	14246643-1205	UT

General Provider Information

NPI Number	:	1346801685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA XIMENA LARRAIN VILLALPANDO MD

Provider Business Mailing Address
First Line	:	6431 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1501
Country	:	US
Telephone Number	:	713-500-5652
Fax Number	:

Provider Business Practice Location Address
First Line	:	6431 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1501
Country	:	US
Telephone Number	:	713-500-5652
Fax Number	:

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

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	05/05/2026

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