NPIMap

Individual provider Active NPI

Derek W Guillory, M.D.

  • Emergency Medicine Physician
  • La Vernia, TX
National Provider Identifier
1710972880
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L5751 Issued in TX
Practice address
202 FM 1346
Suite 2
La Vernia, TX 78121
Phone
(830) 779-3200
Fax
(830) 779-3211
NPI assigned
Sep 15, 2005
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L5751 TX Primary

Addresses

Primary practice location

202 FM 1346
Suite 2
La Vernia, TX 78121

Mailing address

503 Avenue a
Suite 1118
San Antonio, TX 78215-1264
Phone (210) 468-3042

Other identifiers 3

IdentifierTypeStateIssuer
167798102MedicaidTX
167798105MedicaidTX
8M8130OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2020 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
River City Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Cec Alamo Heights ER Physicians PLLC Past Accepting new patients
La Vernia Erl Acquisition Partners LLC PastSince Apr 1, 2025 Accepting new patients
Complete Emergency Care I LLC Past Accepting new patients
Complete Emergency Care la Vernia LLC Past Accepting new patients
Alamo Heights Complete Care LLC Past Accepting new patients
2013 Broadway Emergency Care LLC Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1710972880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 AVENUE A",
            "address_2": "SUITE 1118",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151264",
            "telephone_number": "210-468-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 FM 1346",
            "address_2": "SUITE 2",
            "city": "LA VERNIA",
            "state": "TX",
            "postal_code": "78121",
            "telephone_number": "830-779-3200",
            "fax_number": "830-779-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "DEREK",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L5751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167798102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167798105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8M8130",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vernia, TX

Sources for this page

Verify at the official NPI Registry.