Provider Demographics
NPI:1437426319
Name:GUZMAN, ASUSENA (PT)
Entity Type:Individual
Prefix:
First Name:ASUSENA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 E COUNTY ROAD 93
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79706-4993
Mailing Address - Country:US
Mailing Address - Phone:432-349-1459
Mailing Address - Fax:
Practice Address - Street 1:8050 DR EMMT HEADLEE ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8016
Practice Address - Country:US
Practice Address - Phone:432-296-6703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1201313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist