Provider Demographics
NPI:1528452406
Name:GUZMAN, JOSE JAVIER
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:JAVIER
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 7TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3218
Mailing Address - Country:US
Mailing Address - Phone:888-478-8432
Mailing Address - Fax:
Practice Address - Street 1:320 SOUTHMORE AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1136
Practice Address - Country:US
Practice Address - Phone:888-478-8432
Practice Address - Fax:346-237-4052
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6198207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty