Provider Demographics
NPI:1730057415
Name:GUZMAN LEGRA, LIOVANNIS (NP)
Entity type:Individual
Prefix:
First Name:LIOVANNIS
Middle Name:
Last Name:GUZMAN LEGRA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:553 ROAD 5822
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-6166
Mailing Address - Country:US
Mailing Address - Phone:713-514-7249
Mailing Address - Fax:972-584-6141
Practice Address - Street 1:1313 HOLLAND ST STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-2873
Practice Address - Country:US
Practice Address - Phone:281-888-3128
Practice Address - Fax:972-584-6141
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-25
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1100126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty