MEDICARE: GUILLERMO JUAN MORELL 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	207RN0300X	Nephrology Physician	H3713 123321	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110235796	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0080GG	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1346238268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMO JUAN MORELL MD

Provider Business Mailing Address
First Line	:	PO BOX 2718
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77588-2718
Country	:	US
Telephone Number	:	713-796-0800
Fax Number	:	713-796-0809

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST
Second Line	:	SUITE 1532
City	:	HOUSTON
State	:	TX
Zip	:	77030-2728
Country	:	US
Telephone Number	:	713-796-0800
Fax Number	:	713-796-0809

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	06/30/2008

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