Individual provider Active NPI

Roberto Luis Villarreal, M.D.

  • Pediatric Cardiology Physician
  • Laredo, TX
National Provider Identifier
1295796175
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
F3370 Issued in TX
Practice address
6553 Metro CT
Suite a
Laredo, TX 78041-9137
Phone
(956) 717-5974
Fax
(956) 791-0736
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X F3370 TX Primary

Addresses

Primary practice location

6553 Metro CT
Suite a
Laredo, TX 78041-9137

Mailing address

6553 Metro CT
Suite a
Laredo, TX 78041-9137
Phone (956) 717-5974

Other identifiers 2

IdentifierTypeStateIssuer
00EU79OtherTXBLUE CROSS BLUE SHIELD ID
130196201MedicaidTX

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
I20060612000286 TX Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 1254340706 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F3370TXMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. Pediatric Cardiology CurrentSince Aug 29, 2010 Accepting new patients

Locations

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

6553 Metro Ct
Ste A
Laredo, TX 78041
Phone (956) 717-5974

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1295796175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6553 METRO CT",
            "address_2": "SUITE A",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780419137",
            "telephone_number": "956-717-5974",
            "fax_number": "956-791-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6553 METRO CT",
            "address_2": "SUITE A",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780419137",
            "telephone_number": "956-717-5974",
            "fax_number": "956-791-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "ROBERTO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "F3370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "00EU79",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130196201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.