MEDICARE: DR. NANCY GUZMAN O.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	152W00000X	Optometrist	7318T	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790934727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY GUZMAN O.D.

Provider Business Mailing Address
First Line	:	9262 CULEBRA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-3571
Country	:	US
Telephone Number	:	210-647-4733
Fax Number	:	210-647-4741

Provider Business Practice Location Address
First Line	:	9262 CULEBRA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-3571
Country	:	US
Telephone Number	:	210-647-4733
Fax Number	:	210-647-4741

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

Provider Enumeration Date	:	09/15/2008
Last Update Date	:	08/26/2021

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