Provider Information for 1912327073
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Ms. ANDREA VILLESCAS
Sex: Female
NPI: 1912327073
Last Updated: 2024-07-31
Certification Date: 2024-07-31
Certification Date: 2024-07-31
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1912327073 | ||||||||
| Enumeration Date | 2014-04-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4014 N 22ND ST MCALLEN, TX 78504-4101 United States Phone: 956-507-0377 | Fax:956-992-1090 | ||||||||
| Primary Practice Address | 3200 SANGUINET ST FORT WORTH, TX 76107-5355 United States Phone: 817-255-2664 | Fax: | ||||||||
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