MEDICARE: JANET MARQUEZ VILLALOBOS

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	3104A0630X	Assisted Living Facility (Behavioral Disturbances)		TX

General Provider Information

NPI Number	:	1639010879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET MARQUEZ VILLALOBOS

Provider Business Mailing Address
First Line	:	7624 RAINBOW CREEK DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2116
Country	:	US
Telephone Number	:	817-812-8466
Fax Number	:

Provider Business Practice Location Address
First Line	:	4216 LAGUNA DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-4456
Country	:	US
Telephone Number	:	817-812-8466
Fax Number	:

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

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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