MEDICARE: DR. MARIO VILLAFANI 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	207L00000X	Anesthesiology Physician	G0926	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8U8362	OTHER	TX	BLUE CROSS PROV. NUMBER

General Provider Information

NPI Number	:	1831139708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIO VILLAFANI MD

Provider Business Mailing Address
First Line	:	275 LANTERN BEND DR
Second Line	:	STE. 400
City	:	HOUSTON
State	:	TX
Zip	:	77090-2831
Country	:	US
Telephone Number	:	281-440-0101
Fax Number	:	281-440-6441

Provider Business Practice Location Address
First Line	:	275 LANTERN BEND DR
Second Line	:	STE. 400
City	:	HOUSTON
State	:	TX
Zip	:	77090-2831
Country	:	US
Telephone Number	:	281-440-0101
Fax Number	:	281-440-6441

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MARIO VILLAFANI MD” Practice Location

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