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NPI Code Detail

MEDICARE: MYRNA CRYSTAL VILLALBA APRN-CNP

MEDICARE:   MYRNA CRYSTAL VILLALBA  APRN-CNP
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
1363LF0000XFamily Nurse Practitioner1065840TX

General Provider Information

NPI Number : 1932851375
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRNA CRYSTAL VILLALBA APRN-CNP
Provider Business Mailing Address
First Line : 230 DEER RIDGE DR
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-5515
Country : US
Telephone Number : 512-766-1400
Fax Number :
Provider Business Practice Location Address
First Line : 230 DEER RIDGE DR
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-5515
Country : US
Telephone Number : 512-766-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2022
Last Update Date : 04/28/2025

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Directions to “ MYRNA CRYSTAL VILLALBA APRN-CNP” Practice Location

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