Organization Active NPI

Gustavo E. Villarreal, M.D., P. a.

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1972729945
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G6038 Issued in TX
Legal business name
GUSTAVO E. VILLARREAL, M.D., P. A.
Practice address
208 Shiloh Dr Ste 1
Laredo, TX 78045-7402
Phone
(956) 722-8484
Fax
(956) 727-8494
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Dr. Gustavo E Villarreal, M.D.
Title
Doctor
Phone
(956) 722-8484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G6038 TX Primary

Addresses

Primary practice location

208 Shiloh Dr Ste 1
Laredo, TX 78045-7402

Mailing address

208 Shiloh Dr Ste 1
Laredo, TX 78045-7402
Phone (956) 722-8484

Other identifiers 1

IdentifierTypeStateIssuer
079740901MedicaidTX

Other names 1

  • Family Practice Villarreal Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1972729945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SHILOH DR STE 1",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780457402",
            "telephone_number": "956-722-8484",
            "fax_number": "956-727-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SHILOH DR STE 1",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780457402",
            "telephone_number": "956-722-8484",
            "fax_number": "956-727-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAVO E. VILLARREAL, M.D., P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "956-722-8484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G6038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079740901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Practice Villarreal",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.