Provider Demographics
NPI:1013219328
Name:GODOY, GUILHERME (MD)
Entity Type:Individual
Prefix:
First Name:GUILHERME
Middle Name:
Last Name:GODOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6620 MAIN ST
Mailing Address - Street 2:SUITE 1325, MS BCM380
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2348
Mailing Address - Country:US
Mailing Address - Phone:713-798-5628
Mailing Address - Fax:713-798-5553
Practice Address - Street 1:6620 MAIN ST
Practice Address - Street 2:SUITE 1325, MS BCM380
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2348
Practice Address - Country:US
Practice Address - Phone:713-798-5628
Practice Address - Fax:713-798-5553
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP4448208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology