Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kylie Lauren Villegas

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1700552791

Kylie Lauren Villegas is a Physician Assistant in San Antonio, Texas. Qualified in 2021, 5 years ago. Practices with Jagannath LLC, a 12-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
5
Licensed in
TX
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

9898 Colonnade Blvd Apt 6207
San Antonio, TX 78230-2271
Phone: (361) 550-8412
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA15623 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1700552791
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 19, 2021
Last updated in NPPESJuly 19, 2022
Certification dateJuly 19, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Jagannath Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in San Antonio