| Leo Villaroman, Md, Pa | |
|
501 Golder Ave Suite 203 Odessa TX 79761-4411 | |
| (432) 687-6203 | |
| (432) 687-6299 |
| Full Name | Leo Villaroman, Md, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 501 Golder Ave, Odessa, Texas |
| Authorized Official Name and Position | Leo D Villaroman (PRESIDENT) |
| Authorized Official Contact | 4326876203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leo Villaroman, Md, Pa 3303 Crestmont Dr Midland TX 79707-4234 Ph: (432) 687-6203 | Leo Villaroman, Md, Pa 501 Golder Ave Suite 203 Odessa TX 79761-4411 Ph: (432) 687-6203 |
| NPI Number | 1609020452 |
|---|---|
| Provider Enumeration Date | 11/06/2008 |
| Last Update Date | 01/13/2009 |
| Medicare PECOS PAC ID | 6305900127 |
|---|---|
| Medicare Enrollment ID | O20090122000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609020452 | NPI | - | NPPES |
| PENDING | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | N1208 (Texas) | Primary |
| Provider Name | Leo D Villaroman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073796330 PECOS PAC ID: 1355404526 Enrollment ID: I20090122000663 |
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