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General NPI Number Information
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NPI Number | 1598406084
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Entity Type | Individual
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Provider Name | RURY JOVANIER SANTIAGO GUZMAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 690 S LOOP 336 W
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City | CONROE
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State | TX
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Zip | 77304-3319
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Country | US
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Telephone | 713-442-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 11511 SHADOW CREEK PKWY
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City | PEARLAND
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State | TX
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Zip | 77584-7298
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Country | US
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Telephone | 713-442-0000
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | V9710
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License Number State | TX
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