NPIMap

Individual provider Active NPI

Imelda V Chan-Villanueva, M.D.

  • Family Medicine Physician
  • College Station, TX
National Provider Identifier
1437319977
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N0685 Issued in TX
Practice address
4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone
(979) 690-4828
Fax
(979) 690-4829
NPI assigned
Jun 9, 2008
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N0685 TX Primary
Family Medicine Physician 207Q00000X 0101243329 VA

Addresses

Primary practice location

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176

Mailing address

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone (979) 690-4828

Other practice location 1

100 W Cross St
Madisonville, TX 77864-2432
Phone (936) 348-3418

Other names 1

  • Dr. Imelda C Villanueva Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090311000144 TX Practitioner - Family Practice 7810053220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

4401 State Hwy 6 S
College Station, TX 77845-4428
Phone (979) 690-4480

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N0685TXMDFamily Medicine Physician
0101243329VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Family Medicine CurrentSince May 14, 2009 Accepting new patients
St Joseph Regional Health Center CurrentSince May 14, 2009 Accepting new patients
Fannin County Hospital Authority Past Accepting new patients
College Station Hospital LP Past Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients

Locations

2800 S Texas Ave
Ste 202
Bryan, TX 77802
Phone (979) 774-2060

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

4421 State Highway 6 S
Ste 100
College Station, TX 77845
Phone (979) 731-5200

100 W Cross St
Madisonville, TX 77864
Phone (409) 348-2631

Organizations & group practices 5

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

Hospital & facility affiliations 6

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1437319977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4828",
            "fax_number": "979-690-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4828",
            "fax_number": "979-690-4829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W Cross St",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "TX",
            "postal_code": "778642432",
            "country_code": "US",
            "telephone_number": "936-348-3418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN-VILLANUEVA",
        "first_name": "IMELDA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0685",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101243329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IMELDA",
            "last_name": "VILLANUEVA",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.