MEDICARE: ROSEMARIE GUZMAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA02971	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8N8718	OTHER	TX	BCBSTX - HOSP BASED
2	8N9797	OTHER	TX	BCBSTX - OFFICE BASED

General Provider Information

NPI Number	:	1710937552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARIE GUZMAN PA-C

Provider Business Mailing Address
First Line	:	1700 WEST LOOP SOUTH
Second Line	:	SUITE 400B
City	:	HOUSTON
State	:	TX
Zip	:	77027-3005
Country	:	US
Telephone Number	:	713-277-2222
Fax Number	:	210-703-0934

Provider Business Practice Location Address
First Line	:	155 LOUETTA CROSSING
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373
Country	:	US
Telephone Number	:	281-528-0278
Fax Number	:	281-528-2975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	10/08/2009

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Directions to “ ROSEMARIE GUZMAN PA-C” Practice Location

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