MEDICARE: DR. RODERICK VILLAROMAN VERGEL DE DIOS M.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	207Q00000X	Family Medicine Physician	K 1713	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
10	080145415	OTHER	TX	MEDICARE RAILROAD PIN

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	MIXED	OTHER	TX	COMMERCIAL INS. PROV NO.
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	5805616	OTHER	TX	AETA PIN
6	A002	OTHER	TX	TRICARE PIN
7	A001	OTHER	TX	CHAMPUS
8	116761	OTHER	TX	SUPERIOR HEALTH PIN
9	0021DF	OTHER	TX	BLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number	:	1528072014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODERICK VILLAROMAN VERGEL DE DIOS M.D.

Provider Business Mailing Address
First Line	:	5105 N MCCOLL RD
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2331
Country	:	US
Telephone Number	:	956-686-6644
Fax Number	:	956-467-1010

Provider Business Practice Location Address
First Line	:	5105 N MCCOLL RD
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2331
Country	:	US
Telephone Number	:	956-686-6644
Fax Number	:	956-467-1010

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	11/03/2025

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