Individual
MA. THERESA M. VILLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4801 ALBERTA AVE, EL PASO, TX 79905
(915) 215-5700
(915) 215-8697
Mailing address
440 RAYNOLDS ST, EL PASO, TX 79905-1613
(915) 215-4480
(915) 215-5386
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M5564
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181613401
—
TX
01
—
8H0439
BCBS OF TEXAS
TX
01
—
S0149254
DPS REGISTRATION NUMBER
TX
Enumeration date
12/12/2006
Last updated
08/23/2021
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