Benjamin Guillermo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J6979 Issued in TX

Practice address

250 Blossom St
Ste 400
Webster, TX 77598-4204

Phone

(281) 604-1300

Fax

(281) 724-0225

NPI assigned

Aug 31, 2005

Last updated

Oct 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1851385272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST",
            "address_2": "STE 400",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984204",
            "telephone_number": "281-604-1300",
            "fax_number": "281-724-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST",
            "address_2": "STE 400",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984204",
            "telephone_number": "281-604-1300",
            "fax_number": "281-724-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLERMO",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080110914",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5994569",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045336701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86Z063",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "87583Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine L Gros, CRNA
• Francisco M Guerra Jr., MD, PHD
• Guidry Maria T MD PA
• Maria T Guidry, M.D.
• Jed Ernie Guilbeau, CRNA
• Caryl Guillermo, MD
• Gulf Coast Integrative Healthcare
• Gulf Coast Pathology Program PLLC
• Joni Patricia Gumban, OTR
• Sanjeev Samuel Gummadi, MD

• Family Medicine Physician in Webster, TX
• Providers in Webster, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.