Provider Demographics
NPI:1235218512
Name:HOMS GUILLOTY, MARITZA I (MD)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:I
Last Name:HOMS GUILLOTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARITZA
Other - Middle Name:I
Other - Last Name:HOMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:2727 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1669
Practice Address - Country:US
Practice Address - Phone:713-442-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4975207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154697001Medicaid
TX154697004Medicaid
TX154697003Medicaid
TX154697004Medicaid
TX8A1757Medicare PIN
TX8A1757Medicare PIN
TX154697001Medicaid
TX8A1758Medicare PIN