Provider Demographics
NPI:1548609035
Name:GUZMAN, TIFFANY LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:LEE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 WILLIAM PENN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3950
Mailing Address - Country:US
Mailing Address - Phone:210-784-7271
Mailing Address - Fax:
Practice Address - Street 1:3602 WILLIAM PENN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3950
Practice Address - Country:US
Practice Address - Phone:210-784-7271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist