Provider Demographics
NPI:1538151634
Name:YLLANA-SHEPPERD, AURORA VILLALUZ (MD)
Entity type:Individual
Prefix:MRS
First Name:AURORA
Middle Name:VILLALUZ
Last Name:YLLANA-SHEPPERD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AURORA
Other - Middle Name:VILLALUZ
Other - Last Name:YLLANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22698 PROFESSIONAL DRIVE
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-358-5574
Mailing Address - Fax:281-358-9677
Practice Address - Street 1:22698 PROFESSIONAL DRIVE
Practice Address - Street 2:SUITE 100B
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-358-5574
Practice Address - Fax:281-358-9677
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8237207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1710600 01Medicaid
TX1710600 01Medicaid
I23996Medicare UPIN