Provider Demographics
NPI:1710937552
Name:GUZMAN, ROSEMARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ROSEMARIE
Other - Middle Name:GUZMAN
Other - Last Name:BRUMBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1700 WEST LOOP SOUTH
Mailing Address - Street 2:SUITE 400B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3005
Mailing Address - Country:US
Mailing Address - Phone:713-277-2222
Mailing Address - Fax:210-703-0934
Practice Address - Street 1:155 LOUETTA CROSSING
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373
Practice Address - Country:US
Practice Address - Phone:281-528-0278
Practice Address - Fax:281-528-2975
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02971363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N8718OtherBCBSTX - HOSP BASED
TX8N9797OtherBCBSTX - OFFICE BASED
TX542188284OtherEIN OFFICE BASED
TX8N8718OtherBCBSTX - HOSP BASED
TX542188284OtherEIN OFFICE BASED
TXP87874Medicare UPIN
TX470856615OtherEIN - HOSP BASED