Individual
RYAN VICTOR VILLEGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1401 W 5TH ST, SHERIDAN, WY 82801-2705
(307) 672-1000
(307) 672-1174
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17568A
WY
207R00000X
Internal Medicine Physician
A-2145-18
NM
207R00000X
Internal Medicine Physician
R2778
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14073
CALIFORNIA MEDICAL LICENSE
CA
01
—
R2778
TEXAS MEDICAL LICENSE
TX
Enumeration date
05/10/2013
Last updated
10/31/2024
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