MEDICARE: MRS. MARIELOU RAMOS-GUZOM M.D.

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	174400000X	Specialist	G7143	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G7143	OTHER	TX	TL#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	760454735	OTHER	TX	TAX ID #
4	HX31	OTHER	TX	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518943828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIELOU RAMOS-GUZOM M.D.

Provider Business Mailing Address
First Line	:	6035 AIRLINE DR
Second Line	:	STE 1
City	:	HOUSTON
State	:	TX
Zip	:	77076-4240
Country	:	US
Telephone Number	:	713-694-2808
Fax Number	:	713-694-2833

Provider Business Practice Location Address
First Line	:	6035 AIRLINE DR
Second Line	:	STE 1
City	:	HOUSTON
State	:	TX
Zip	:	77076-4240
Country	:	US
Telephone Number	:	713-694-2808
Fax Number	:	713-694-2833

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	05/21/2012

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Directions to “ MRS. MARIELOU RAMOS-GUZOM M.D.” Practice Location

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