Active NPI
Everardo Villarreal, PTA
- Physical Therapy Assistant
- Edinburg, TX
National Provider Identifier
1871071779
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 18, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2051768
- Practice address
- 411 N 8TH Ave
Edinburg, TX 78541-3309 - Phone
- (956) 336-5642
- NPI assigned
- Aug 2, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2051768 | TX | Primary |
Addresses
Primary practice location
411 N 8TH Ave
Edinburg, TX 78541-3309
Mailing address
2623 W Rodgers Rd
Edinburg, TX 78540
Phone (956) 318-0523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2051768 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1871071779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2623 W RODGERS RD",
"city": "EDINBURG",
"state": "TX",
"postal_code": "78540",
"telephone_number": "956-318-0523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N 8TH AVE",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785413309",
"telephone_number": "956-336-5642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLARREAL",
"first_name": "EVERARDO",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-02",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2051768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edinburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.