Provider Demographics
NPI:1396705471
Name:ROBINSON, GUILFORD (MD)
Entity type:Individual
Prefix:
First Name:GUILFORD
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 BROADWAY ST
Mailing Address - Street 2:610
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5710
Mailing Address - Country:US
Mailing Address - Phone:210-930-7908
Mailing Address - Fax:210-822-9331
Practice Address - Street 1:5150 BROADWAY ST
Practice Address - Street 2:610
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5710
Practice Address - Country:US
Practice Address - Phone:210-930-7908
Practice Address - Fax:210-822-9331
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7577207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141559801Medicaid
TX141559801Medicaid
TX00089RMedicare ID - Type Unspecified