MEDICARE: GRACIELA VILLARREAL 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	208000000X	Pediatrics Physician	H7041	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

General Provider Information

NPI Number	:	1952481293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACIELA VILLARREAL MD

Provider Business Mailing Address
First Line	:	8080 N STADIUM DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1829
Country	:	US
Telephone Number	:	832-822-3400
Fax Number	:	832-825-3399

Provider Business Practice Location Address
First Line	:	8080 N STADIUM DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1829
Country	:	US
Telephone Number	:	832-822-3400
Fax Number	:	832-825-3399

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	05/13/2015

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