Individual
MARK CHARLES VILLARREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12222 MERIT DR STE 600, DALLAS, TX 75251-3294
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-6524
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J3387
TX
207L00000X
Anesthesiology Physician
Primary
J3387
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100166090A
—
OK
05
—
140934401
—
TX
05
—
140934404
—
TX
01
—
8EH598
BCBS
TX
01
—
P01338257
RR
TX
Enumeration date
02/22/2006
Last updated
10/04/2022
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