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General NPI Number Information
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NPI Number | 1780734699
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Entity Type | Individual
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Provider Name | MANUEL G GUAJARDO M.D., P.A.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 301 LORENALY DRIVE SUITE E
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4446
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Country | US
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Telephone | 956-350-5007
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Fax | 956-350-0945
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Provider Business Mailing Address
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Address Line | 301 LORENALY DRIVE SUITE E
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4446
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Country | US
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Telephone | 956-350-5007
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Fax | 956-350-0945
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G5128
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License Number State | TX
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