Individual provider Active NPI

Debra Borjon Villa

  • Licensed Vocational Nurse
  • San Antonio, TX
National Provider Identifier
1043799521
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
333010 Issued in TX
Practice address
11502 Fort Smith
San Antonio, TX 78245-3691
Phone
(707) 330-9155
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164X00000X 333010 TX Primary

Addresses

Primary practice location

11502 Fort Smith
San Antonio, TX 78245-3691

Mailing address

11502 Fort Smith
San Antonio, TX 78245-3691
Phone (707) 330-9155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
333010TXMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1043799521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11502 FORT SMITH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782453691",
            "telephone_number": "707-330-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11502 FORT SMITH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782453691",
            "telephone_number": "707-330-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "DEBRA",
        "middle_name": "BORJON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "333010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.