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NPI Code Detail

MEDICARE: DR. SAMUEL JOSEPH VILLAREALE DPT

MEDICARE: DR. SAMUEL JOSEPH VILLAREALE DPT
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
1225100000XPhysical Therapist3030NV

General Provider Information

NPI Number : 1871223602
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL JOSEPH VILLAREALE DPT
Provider Business Mailing Address
First Line : 6900 N PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-791-9000
Fax Number :
Provider Business Practice Location Address
First Line : 6900 N PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-791-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2022
Last Update Date : 04/14/2026

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