Organization Active NPI

Leo Villaroman, MD, PA

  • Family Medicine Physician
  • Odessa, TX
National Provider Identifier
1609020452
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N1208 Issued in TX
Legal business name
LEO VILLAROMAN, MD, PA
Practice address
501 Golder Ave
Suite 203
Odessa, TX 79761-4411
Phone
(432) 687-6203
Fax
(432) 687-6299
NPI assigned
Nov 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Authorized official

Name
Leo D Villaroman, MD
Title
President
Phone
(432) 687-6203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X N1208 TX Primary

Addresses

Primary practice location

501 Golder Ave
Suite 203
Odessa, TX 79761-4411

Mailing address

3303 Crestmont Dr
Midland, TX 79707-4234
Phone (432) 687-6203

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidTX

National Provider Directory

National Provider Directory

Locations

501 Golder Ave
Ste 203
Odessa, TX 79761
Phone (432) 687-6203

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231804800000",
    "number": "1609020452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 CRESTMONT DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797074234",
            "telephone_number": "432-687-6203",
            "fax_number": "432-687-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOLDER AVE",
            "address_2": "SUITE 203",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614411",
            "telephone_number": "432-687-6203",
            "fax_number": "432-687-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO VILLAROMAN, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2009-01-13",
        "status": "A",
        "authorized_official_last_name": "VILLAROMAN",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "432-687-6203",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.