Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 134062-1 | NY |
NPI | 1336230374 |
---|---|
Provider Name | Dr. Bernardo F Villacis |
First Address | San Antonio, TX 78216-1703 |
Second Address | Fort Sam Houston, TX 78234-4501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |