Individual
MR. CARLOS RICARDO VILLANUEVA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
350 REVERE ST, EL PASO, TX 79905-1633
(915) 564-6100
Mailing address
3201 MANNY AGUILERA DR, EL PASO, TX 79936-2760
(915) 731-0920
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
234059
TX
Other
Enumeration date
08/08/2024
Last updated
09/06/2024
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