NPIMap

Eduardo Guzman MD PA

Organization Active NPI General Practice Physician · Penitas, TX

NPI 1649401951 · NPPES record last updated Aug 19, 2011

Key facts

NPI
1649401951
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
License
M2631 (TX)
Legal business name
EDUARDO GUZMAN MD PA
Practice address
2308 Hwy 83 Ste F
Penitas, TX 78576-8399
Phone
(956) 519-9100
Fax
(956) 519-9900
NPI assigned
Aug 4, 2009
Organization subpart
No

Authorized official

Name
Eduardo Guzman, MD PA NPI 1295780005
Title
Owner
Phone
(956) 519-9100

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 23

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100316000883 TX Part B Supplier - Clinic/Group Practice 8325173347 Receives reassigned benefits from 4 practitioners
Practice locations: Penitas, TX

National Provider Directory

Locations

2308 Expressway 83
Ste F
Penitas, TX 78576

712 S Cage Blvd
Pharr, TX 78577
Phone (956) 783-1900

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X M2631 TX Yes

Addresses

Primary practice location

2308 Hwy 83 Ste F
Penitas, TX 78576-8399

Mailing address

2308 Hwy 83 Ste F
Penitas, TX 78576-8399
Phone (956) 519-9100

Other identifiers

IdentifierTypeStateIssuer
0A6000OtherTXMEDICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 19, 2011.

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1649401951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 HWY 83 STE F",
            "city": "PENITAS",
            "state": "TX",
            "postal_code": "785768399",
            "telephone_number": "956-519-9100",
            "fax_number": "956-519-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 HWY 83 STE F",
            "city": "PENITAS",
            "state": "TX",
            "postal_code": "785768399",
            "telephone_number": "956-519-9100",
            "fax_number": "956-519-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUARDO GUZMAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-04",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-519-9100",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "M2631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0A6000",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penitas, TX

All providers in Penitas, TX · General Practice Physician in Texas

Sources for this page

Verify at the official NPI Registry.