Basic Information
Provider Information
NPI: 1033557566
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUZMAN
FirstName: ADRIANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1900 S JACKSON RD STE 2AND3
Address2:  
City: MCALLEN
State: TX
PostalCode: 785031588
CountryCode: US
TelephoneNumber: 9566304400
FaxNumber: 9566304447
Practice Location
Address1: 1900 S JACKSON RD STE 2AND3
Address2:  
City: MCALLEN
State: TX
PostalCode: 785031588
CountryCode: US
TelephoneNumber: 9566304400
FaxNumber: 9566304447
Other Information
ProviderEnumerationDate: 06/06/2013
LastUpdateDate: 06/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X115456TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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