Individual ProviderAzaret VilledaNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6500 N Mopac Expy Ste 2, Austin, TX 78731-3282(512) 963-0943PECOS EnrollmentBased on the most recent information from CMS, provider Azaret Villeda is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:13 AM.Profile DetailsProvider ID1538824412Provider TypeIndividualFull NameVilleda, AzaretGenderFemaleSole ProprietorYesEnumeration Date11/4/2021Last Updated12/8/2021Contact InformationPractice LocationPractice Address6500 N Mopac Expy Ste 2, Austin, TX 78731-3282Phone(512) 963-0943FaxUnlisted FaxMailing LocationMailing Address11413 Sprinkle Cutoff Rd, Austin, TX 78754-5410Phone(512) 963-0943FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense1057784Texas