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Individual

MRS. CAROLYN THERESA VILLARRUBIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1150 DEVEREUX DR, LEAGUE CITY, TX 77573
(281) 332-8608
(281) 332-5283
Mailing address
1150 DEVEREUX DR, LEAGUE CITY, TX 77573
(281) 332-8608
(281) 332-5283

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D7496
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10017081
AMERIGROUP
TX
01
82865G
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/18/2006
Last updated
01/17/2008
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