Provider Demographics
NPI:1821005950
Name:GUILLEN, TIU & ASSOCIATES MD PA
Entity type:Organization
Organization Name:GUILLEN, TIU & ASSOCIATES MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-287-7500
Mailing Address - Street 1:802 E UNIVERSITY DR STE B
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3632
Mailing Address - Country:US
Mailing Address - Phone:956-287-7500
Mailing Address - Fax:
Practice Address - Street 1:802 E UNIVERSITY DR STE B
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3632
Practice Address - Country:US
Practice Address - Phone:956-287-7500
Practice Address - Fax:956-287-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0793208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX107540002Medicaid
TX129535405Medicaid
TX124994805Medicaid