Provider Demographics
NPI:1427546555
Name:GUZMAN, MARCOS XAVIER (BS)
Entity Type:Individual
Prefix:
First Name:MARCOS
Middle Name:XAVIER
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 ANNA MARIE CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-1731
Mailing Address - Country:US
Mailing Address - Phone:915-487-8369
Mailing Address - Fax:
Practice Address - Street 1:1721 ANNA MARIE CT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-1731
Practice Address - Country:US
Practice Address - Phone:915-487-8369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician