MEDICARE: CESAR ALEJANDRO VILLARREAL

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	1223P0700X	Prosthodontics	39738	TX

General Provider Information

NPI Number	:	1639954340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CESAR ALEJANDRO VILLARREAL

Provider Business Mailing Address
First Line	:	2219 MEADOW POINT DR
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-3813
Country	:	US
Telephone Number	:	830-325-1953
Fax Number	:

Provider Business Practice Location Address
First Line	:	2219 MEADOW POINT DR
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-3813
Country	:	US
Telephone Number	:	830-325-1953
Fax Number	:

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

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	08/30/2023

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Directions to “ CESAR ALEJANDRO VILLARREAL ” Practice Location

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