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General NPI Number Information
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NPI Number | 1568531630
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Entity Type | Organization
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Legal Business Name | OCTAVIO E. GUZMAN M.D., PA
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/30/2007
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Provider Practice Location Address
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Address Line | 6826 SPRINGFIELD AVE STE 101
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City | LAREDO
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State | TX
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Zip | 78041-2213
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Country | US
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Telephone | 956-717-1775
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Fax | 956-717-1725
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Provider Business Mailing Address
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Address Line | PO BOX 450768
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City | LAREDO
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State | TX
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Zip | 78045-0018
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Country | US
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Telephone | 956-717-1775
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Fax | 956-717-1725
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OCTAVIO E GUZMAN
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Credential | M.D.
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Telephone | 956-717-1775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | J5338
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License Number State | TX
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