Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | P3478 | TX |
NPI | 1689861007 |
---|---|
Provider Name | Dr. Filomena Hazel Rocha Villa |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78207-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2007 |
Last Update Date | 26/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300915101 | (05) | TX |
300915102 | CSHCN (01) | TX |