Provider Demographics
NPI:1760867964
Name:GUZMAN, JOSE JUAN JR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JUAN
Last Name:GUZMAN
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 SAN GABRIEL ST
Mailing Address - Street 2:#7304
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7290
Mailing Address - Country:US
Mailing Address - Phone:956-458-2643
Mailing Address - Fax:
Practice Address - Street 1:901 W EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3734
Practice Address - Country:US
Practice Address - Phone:956-783-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist