Provider Demographics
NPI:1972999290
Name:DEGUZMAN, MERLY
Entity type:Individual
Prefix:MS
First Name:MERLY
Middle Name:
Last Name:DEGUZMAN
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 1:19333 HIGHWAY 59 N STE 280
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4256
Mailing Address - Country:US
Mailing Address - Phone:281-319-8500
Mailing Address - Fax:281-319-8520
Practice Address - Street 1:9813 MEMORIAL BLVD.
Practice Address - Street 2:SUITE H
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-319-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily