Provider Demographics
NPI:1386379485
Name:GUZMAN, ASHLEY LAYNE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAYNE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 CYPRESS MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8381
Mailing Address - Country:US
Mailing Address - Phone:409-256-1660
Mailing Address - Fax:
Practice Address - Street 1:6608 GULF FWY STE 100
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-4095
Practice Address - Country:US
Practice Address - Phone:409-655-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1086269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1086269Medicaid
TX1086269OtherINSURANCE