# LOPE T VILLA JR MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932169406
- **Authorized official:** DR. LOPE TAN VILLA JR. MD (PRESIDENT)
- **Authorized official phone:** (410) 296-4242

## Contact information

- **Practice address:** 120 SISTER PIERRE DRIVE, STE 103, TOWSON, MD 21204
- **Practice address phone:** (410) 296-4242
- **Practice address fax:** (410) 828-5613
- **Mailing address:** 120 SISTER PIERRE DRIVE, STE 103, TOWSON, MD 21204
- **Mailing address phone:** (410) 296-4242
- **Mailing address fax:** (410) 828-5613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | D15824 | MD | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 08/22/2020