Roberto L Villarrealdds

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22476 Issued in TX

Legal business name

ROBERTO L VILLARREALDDS

Practice address

1302 S General McMullen Dr Ste 102
San Antonio, TX 78237-4200

Phone

(210) 432-7851

Fax

(210) 432-1157

NPI assigned

Mar 1, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Roberto Luis Villarreal, DDS

Title

President/Owner

Phone

(210) 432-7851

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1528332004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 S GENERAL MCMULLEN DR STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782374200",
            "telephone_number": "210-432-7851",
            "fax_number": "210-432-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 S GENERAL MCMULLEN DR STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782374200",
            "telephone_number": "210-432-7851",
            "fax_number": "210-432-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTO L VILLARREALDDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "210-432-7851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "22476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182496301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.