Provider Demographics
NPI:1346238268
Name:MORELL, GUILLERMO JUAN (MD)
Entity Type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:JUAN
Last Name:MORELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2718
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77588-2718
Mailing Address - Country:US
Mailing Address - Phone:713-796-0800
Mailing Address - Fax:713-796-0809
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 1532
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2728
Practice Address - Country:US
Practice Address - Phone:713-796-0800
Practice Address - Fax:713-796-0809
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3713 123321207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110235796OtherMEDICARE RAILROAD
TX1342966-08Medicaid
TX0080GGOtherBLUE CROSS BLUE SHIELD
TX0080GGOtherBLUE CROSS BLUE SHIELD