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General NPI Number Information
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NPI Number | 1083242135
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Entity Type | Individual
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Provider Name | LUIS M GUEVARA DO
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Gender | Male
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Dates
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Enumeration Date | 04/01/2020
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 1119 FENWICK DR STE 204
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City | LAREDO
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State | TX
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Zip | 78041-2971
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Country | US
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Telephone | 956-441-0646
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 E SAUNDERS ST
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City | LAREDO
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State | TX
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Zip | 78041-5474
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Country | US
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Telephone | 956-796-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | T5328
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | T5328
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License Number State | TX
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