Provider Demographics
NPI:1992788400
Name:GUZMAN, HORACIO J (MD)
Entity type:Individual
Prefix:
First Name:HORACIO
Middle Name:J
Last Name:GUZMAN
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:PO BOX 201157
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-1157
Mailing Address - Country:US
Mailing Address - Phone:281-649-7310
Mailing Address - Fax:713-484-6649
Practice Address - Street 1:11914 ASTORIA BLVD
Practice Address - Street 2:#500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6064
Practice Address - Country:US
Practice Address - Phone:281-484-3981
Practice Address - Fax:281-481-0182
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3935207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031809903Medicaid
TXB23217Medicare UPIN
TX031809903Medicaid