Provider Demographics
NPI:1659879039
Name:GUZMAN, DAVID (LVN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E YAGER LN APT 523
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1673
Mailing Address - Country:US
Mailing Address - Phone:512-969-9787
Mailing Address - Fax:
Practice Address - Street 1:840 CTY RD 420
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669
Practice Address - Country:US
Practice Address - Phone:830-798-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX312025164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse