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General NPI Number Information
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NPI Number | 1497541577
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Entity Type | Individual
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Provider Name | GUILLERMO ANTONIO VAQUERO
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Gender | Male
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 1515 HOLCOMBE BLVD
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City | HOUSTON
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State | TX
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Zip | 77030-4000
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Country | US
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Telephone | 877-632-6789
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Fax |
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Provider Business Mailing Address
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Address Line | 12614 ALTUVE DR
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City | HOUSTON
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State | TX
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Zip | 77034-1561
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Country | US
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Telephone | 714-415-8302
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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