MEDICARE: EVAN CRAIG GUZ 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	207P00000X	Emergency Medicine Physician	J6983	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8N2596	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780670059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVAN CRAIG GUZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4346
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	713-637-1146
Fax Number	:

Provider Business Practice Location Address
First Line	:	16088 SAN PEDRO AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-2251
Country	:	US
Telephone Number	:	877-978-0799
Fax Number	:	281-298-5311

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	12/16/2014

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