MEDICARE: DR. GIL VILLARREAL JR. DDS

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	1223G0001X	General Practice Dentistry	15463	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871576181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GIL VILLARREAL JR. DDS

Provider Business Mailing Address
First Line	:	1200 E RIDGE RD
Second Line	:	SUITE 9
City	:	MCALLEN
State	:	TX
Zip	:	78503-1527
Country	:	US
Telephone Number	:	956-631-7177
Fax Number	:	956-631-7168

Provider Business Practice Location Address
First Line	:	1200 E RIDGE RD
Second Line	:	SUITE 9
City	:	MCALLEN
State	:	TX
Zip	:	78503-1527
Country	:	US
Telephone Number	:	956-631-7177
Fax Number	:	956-631-7168

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	03/20/2013

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