MEDICARE: DR. YVONNE M VILLARREAL 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	0101230416	VA

General Provider Information

NPI Number	:	1558360214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVONNE M VILLARREAL M.D.

Provider Business Mailing Address
First Line	:	14 SECRETARIAT DR
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22556-6671
Country	:	US
Telephone Number	:	540-286-3729
Fax Number	:	540-286-2929

Provider Business Practice Location Address
First Line	:	385 GARRISONVILLE RD
Second Line	:	SUITE 211
City	:	STAFFORD
State	:	VA
Zip	:	22554-1545
Country	:	US
Telephone Number	:	540-657-1223
Fax Number	:	540-657-1220

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	09/13/2010

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