Provider Demographics
NPI:1205179165
Name:GUZMAN, DELMAR R (LSA)
Entity Type:Individual
Prefix:
First Name:DELMAR
Middle Name:R
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SUGAR CREEK CENTER BLVD STE 618
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3540
Mailing Address - Country:US
Mailing Address - Phone:326-554-1418
Mailing Address - Fax:713-457-5188
Practice Address - Street 1:1 SUGAR CREEK BLVD
Practice Address - Street 2:STE 618
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:832-655-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19157857246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00457OtherTEXAS MEDICAL BOARD
TX8QN036OtherBCBS - BLUE STAR SURGICAL ASSISTANTS
TX8QN119OtherBCBS - UNIVERSAL SURGICAL MSO
TX8QN120OtherBCBS - UNIVERSAL SURGICAL ASSISTANTS
TX8QN038OtherBCBS - XCITE SURGICAL