Healthcare Provider Details

I. General information

NPI: 1013959477
Provider Name (Legal Business Name): DAREN MICHAEL GUERTIN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W PASADENA BLVD
DEER PARK TX
77536-4870
US

IV. Provider business mailing address

PO BOX 58538
WEBSTER TX
77598-8538
US

V. Phone/Fax

Practice location:
  • Phone: 281-479-5311
  • Fax: 281-479-0748
Mailing address:
  • Phone: 281-479-5311
  • Fax: 281-479-0748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1780
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1780
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005677
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: