Individual
LUIS S VILELLA-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4671 38TH ST S, FARGO, ND 58104-7866
(877) 749-7428
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(877) 749-7428
(512) 628-3314
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
9273
ND
208100000X
Physical Medicine & Rehabilitation Physician
MD2005-0853
NM
Other
Enumeration date
02/09/2015
Last updated
12/31/2019
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