Provider Demographics
NPI:1326055013
Name:AYERAS, GUIA AVECILLA (LPT)
Entity Type:Individual
Prefix:MRS
First Name:GUIA
Middle Name:AVECILLA
Last Name:AYERAS
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 BONHOMME RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-6720
Mailing Address - Country:US
Mailing Address - Phone:832-228-5331
Mailing Address - Fax:
Practice Address - Street 1:706 WINDY HILL RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-1855
Practice Address - Country:US
Practice Address - Phone:832-228-5331
Practice Address - Fax:832-228-5331
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1039527225100000X
GA011055225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist