Organization Active NPI

Manuel G Guajardo Mdpa

  • Obstetrics & Gynecology Physician
  • Brownsville, TX
National Provider Identifier
1508916735
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MANUEL G GUAJARDO MDPA
Practice address
300 Lorenaly Dr
Brownsville, TX 78526-4060
Phone
(956) 350-5007
Fax
(956) 350-0945
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Manuel G Guajardo, M.D. P.A.
Title
Physician, Owner
Phone
(956) 350-5007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

300 Lorenaly Dr
Brownsville, TX 78526-4060

Mailing address

300 Lorenaly Dr
Brownsville, TX 78526-4060
Phone (956) 350-5007

Other identifiers 1

IdentifierTypeStateIssuer
0848004MedicaidTX

National Provider Directory

National Provider Directory

Locations

1024 E Los Ebanos Blvd
Brownsville, TX 78520
Phone (956) 350-5007

300 Lorenaly Dr
Brownsville, TX 78526
Phone (956) 350-5007

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508916735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LORENALY DR",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785264060",
            "telephone_number": "956-350-5007",
            "fax_number": "956-350-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LORENALY DR",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785264060",
            "telephone_number": "956-350-5007",
            "fax_number": "956-350-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL G GUAJARDO MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUAJARDO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "956-350-5007",
        "authorized_official_credential": "M.D. P.A."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0848004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.