Individual provider Active NPI

David Fernando Villacres, MD

  • Specialist
  • Humble, TX
National Provider Identifier
1245267343
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H7099 Issued in TX
Practice address
3407 Rivers Edge TRL
Humble, TX 77339-2634
Phone
(281) 361-5990
Fax
(281) 361-5883
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X H7099 TX Primary

Addresses

Primary practice location

3407 Rivers Edge TRL
Humble, TX 77339-2634

Mailing address

3407 Rivers Edge TRL
Humble, TX 77339-2634
Phone (281) 361-5990

Other identifiers 1

IdentifierTypeStateIssuer
089831402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323001733 TX Practitioner - Physical Medicine and Rehabilitation 8123919636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Texas Medical School at San Antonio, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3407 Rivers Edge TRL
Humble, TX 77339-2634

Hospital & facility affiliations

  • Memorial Hermann Northeast Hospital Hospital, Humble, TX, CCN 450684

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H7099TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
David F Villacres Mdpa CurrentSince May 7, 1992 Accepting new patients

Locations

3407 Rivers Edge Trl
Kingwood, TX 77339
Phone (281) 361-5990

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1245267343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 RIVERS EDGE TRL",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773392634",
            "telephone_number": "281-361-5990",
            "fax_number": "281-361-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 RIVERS EDGE TRL",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773392634",
            "telephone_number": "281-361-5990",
            "fax_number": "281-361-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACRES",
        "first_name": "DAVID",
        "middle_name": "FERNANDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "H7099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089831402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.