Provider Demographics
NPI:1124389275
Name:BARRERA, GUILLERMO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:
Last Name:BARRERA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1035 DAIRY ASHFORD RD
Mailing Address - Street 2:SUITE 154
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4608
Mailing Address - Country:US
Mailing Address - Phone:713-589-6400
Mailing Address - Fax:713-779-9813
Practice Address - Street 1:1035 DAIRY ASHFORD RD
Practice Address - Street 2:SUITE 154
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4608
Practice Address - Country:US
Practice Address - Phone:713-589-6400
Practice Address - Fax:713-779-9813
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ06597181208D00000X
TX12-155246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist