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NPI Code Detail

MEDICARE: JENNIFER VILLARREAL

MEDICARE:   JENNIFER  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
1225X00000XOccupational Therapist118333TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1118333OTHERTXSTATE LICENSE
2118333OTHERTXSTATE LICESNSE

General Provider Information

NPI Number : 1649706664
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER VILLARREAL
Provider Business Mailing Address
First Line : PO BOX 1136
Second Line :
City : MERCEDES
State : TX
Zip : 78570-1136
Country : US
Telephone Number : 956-514-1551
Fax Number :
Provider Business Practice Location Address
First Line : 208 STARR ST STE 2
Second Line :
City : MERCEDES
State : TX
Zip : 78570-2736
Country : US
Telephone Number : 956-541-1551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 07/21/2022

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Directions to “ JENNIFER VILLARREAL ” Practice Location

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