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Individual

LEA MARIE VILLADIEGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
6621 FANNIN ST # MC1-3270, HOUSTON, TX 77030-2358
(832) 824-2296
Mailing address
7510 ROSEPATH LN, RICHMOND, TX 77407-2086
(713) 253-0288

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
581020
TX
363L00000X
Nurse Practitioner
Primary
AP142714
TX

Other

Enumeration date
08/01/2019
Last updated
08/03/2021
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