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General NPI Number Information
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NPI Number | 1619990462
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Entity Type | Individual
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Provider Name | GUILLERMO ACEVEDO
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 96 BERRY RD
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City | HOUSTON
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State | TX
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Zip | 77022
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Country | US
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Telephone | 713-699-0500
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Fax | 713-694-4300
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Provider Business Mailing Address
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Address Line | 7048 BISSONNET ST
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City | HOUSTON
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State | TX
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Zip | 77074-6010
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Country | US
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Telephone | 713-776-3906
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Fax | 713-776-0150
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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 | D9064
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License Number State | TX
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