MEDICARE: DR. GUILLERMO BARRERA JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	06597181	ZZ

General Provider Information

NPI Number	:	1124389275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUILLERMO BARRERA JR. MD

Provider Business Mailing Address
First Line	:	1035 DAIRY ASHFORD RD
Second Line	:	SUITE 154
City	:	HOUSTON
State	:	TX
Zip	:	77079-4608
Country	:	US
Telephone Number	:	713-589-6400
Fax Number	:	713-779-9813

Provider Business Practice Location Address
First Line	:	1035 DAIRY ASHFORD RD
Second Line	:	SUITE 154
City	:	HOUSTON
State	:	TX
Zip	:	77079-4608
Country	:	US
Telephone Number	:	713-589-6400
Fax Number	:	713-779-9813

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	01/13/2017

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