MEDICARE: MIGUEL VILLARINO 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	207Q00000X	Family Medicine Physician	K4286	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

General Provider Information

NPI Number	:	1588776447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL VILLARINO MD

Provider Business Mailing Address
First Line	:	4151 BOB BULLOCK LOOP
Second Line	:	SUITE 103
City	:	LAREDO
State	:	TX
Zip	:	78043-4741
Country	:	US
Telephone Number	:	956-729-9738
Fax Number	:	956-729-0291

Provider Business Practice Location Address
First Line	:	4151 BOB BULLOCK LOOP
Second Line	:	SUITE 103
City	:	LAREDO
State	:	TX
Zip	:	78043-4741
Country	:	US
Telephone Number	:	956-729-9738
Fax Number	:	956-729-0291

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/07/2014

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Directions to “ MIGUEL VILLARINO MD” Practice Location

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