MEDICARE: MR. YOSHIO IVAN 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	2255A2300X	Athletic Trainer	AT10346	TX

General Provider Information

NPI Number	:	1841142684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YOSHIO IVAN VILLARREAL

Provider Business Mailing Address
First Line	:	4516 CARROL RD
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78574-0415
Country	:	US
Telephone Number	:	956-321-9740
Fax Number	:

Provider Business Practice Location Address
First Line	:	4501 W EXPRESSWAY 83
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78503-0029
Country	:	US
Telephone Number	:	956-321-9740
Fax Number	:

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

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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