SANDRA VILLAVICENCIO (NPI# 1881034395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881034395 |
| Entity Type | Individual |
| Full Name | SANDRA VILLAVICENCIO |
| Credential | M.D. |
| Practice Address |
4875 Maxwell Ave El Paso TX 79904-1559 |
| Practice Telephone | 9155337057 |
| Mailing Telephone | 9155337057 |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Q7502 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
4875 MAXWELL AVE |
| City | EL PASO |
| State | TX |
| Zip Code | 79904-1559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609973221 | Audree Jean Reynolds | Nurse Practitioner | 4875 Maxwell Ave, El Paso, TX 79904-1450 | 2006-09-17 |
| 1104423656 | Lissette Angelica Amparan | Social Worker | 4875 Maxwell Ave, El Paso, TX 79904-1559 | 2020-10-07 |
| 1770895815 | Daniel William Sudimack | Dentist | 4875 Maxwell Ave, El Paso, TX 79904-1559 | 2010-07-06 |
| 1992016620 | Crystal Estrada | Dentist | 4875 Maxwell Ave, El Paso, TX 79904-1559 | 2010-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700385762 | Matthew Jacob Lares | Physical Therapist | 4242 Hondo Pass Drive Suite 110, El Paso, TX 79904 | 2018-02-06 |
| 1598263170 | Jennifer Suzanne Banks | Registered Nurse | 7760 Alabama Street, El Paso, TX 79904 | 2018-01-29 |
| 1508306796 | Jacqueline Gazelle Romero | Specialist/Technologist | 4601 Hondo Pass Dr Ste A, El Paso, TX 79904 | 2017-03-07 |
| 1306215967 | Dsi El Paso North, LLC | Clinic/Center | 3359 Fred Wilson Avenue, El Paso, TX 79904 | 2015-09-24 |
| 1225380587 | El Paso Eyecare Pllc | Optometrist | 9009 Gateway Blvd. South, El Paso, TX 79904 | 2012-10-11 |
| 1154617819 | Edward J Valdez | Durable Medical Equipment & Medical Supplies | 8888 Dyer St Ste 102, El Paso, TX 79904 | 2011-06-21 |
| 1548469521 | Wainwright Family Resource Center | Pediatrics | 4417 Tetons, El Paso, TX 79904 | 2007-07-11 |
| 1730256355 | Luis Raul Munoz | Pediatrics | 2900 N. Kansas St, El Paso, TX 79904 | 2006-11-29 |
| 1912012139 | Travis M Hausler | Dentist | 4721 Sierra Madre, El Paso, TX 79904 | 2006-08-20 |
| 1962422097 | Alexandra Jordan | Nurse Practitioner | 4417 Tetons Drive, El Paso, TX 79904 | 2006-07-20 |
| Find all providers in zip 79904 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790983229 | Raul A Najera | Family Medicine | 7878 Gateway Blvd E, Suite 202, El Paso, TX 79915-1802 | 2007-07-05 |
| 1437364536 | Texas Tech University Health Sciences Center | Family Medicine | 9849 Kenworthy St, El Paso, TX 79924-4402 | 2007-05-11 |
| 1457420242 | Jesus Alonzo | Family Medicine | 8061 Alameda Ave, El Paso, TX 79915-4705 | 2006-11-07 |
| 1083794937 | Vera Eloise Carter | Family Medicine | 5001 N Piedras St, El Paso, TX 79930-4210 | 2006-10-16 |
| 1932217445 | Catalino D. Layumas | Family Medicine | 5001 N Piedras St, El Paso, TX 79930-4210 | 2006-08-25 |
| 1235242686 | Orest Andrew Chalupa | Family Medicine | 5001 N Piedras St, El Paso, TX 79930-4210 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686496 | Hill Country Health Pllc | Family Medicine | 1010 Ranch Road 620 S Ste 107, Lakeway, TX 78734-5638 | 2020-10-14 |
| 1174139471 | Stacie Leann Herring | Family Medicine | 1300 Tx-107, La Villa, TX 78562 | 2020-09-22 |
| 1336753508 | Woodlands Diagnostic Clinic, Pa | Family Medicine | 9201 Pinecroft Dr Ste 200, Shenandoah, TX 77380-3889 | 2020-09-03 |
| 1932738465 | Arlington Integrative Medicine LLC | Family Medicine | 1420 N Cooper St Ste 109, Arlington, TX 76011-8530 | 2020-04-06 |
| 1396379772 | Heights Total Wellness Clinic, Pllc | Family Medicine | 1801 Durham Dr Ste 4, Houston, TX 77007-2272 | 2020-02-25 |
| 1063043271 | Katie Lianne Jubala | Family Medicine | 129 Park Place Cir, Iowa Park, TX 76367-1064 | 2020-01-28 |
| 1558909879 | Forrest Duane Giles | Family Medicine | 152 Mcvoid Rd, Springtown, TX 76082-5929 | 2019-12-17 |
| 1710525225 | Mary Osawe | Family Medicine | 1308 Winecup Ct, Allen, TX 75002-0983 | 2019-12-16 |
| 1609411735 | Sara E Bellard | Family Medicine | 4735 Ridgewood Ave, Port Arthur, TX 77642-6612 | 2019-11-13 |
| 1528600574 | Shearren Johnson | Family Medicine | 2162 Us Highway 259 S, Diana, TX 75640-3510 | 2019-10-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.