Provider Demographics
NPI:1821024019
Name:TORRE, GUILLERMO (MD)
Entity Type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:
Last Name:TORRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SMITH TOWER, SUITE 1901
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-1100
Mailing Address - Fax:713-790-2643
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SMITH TOWER, SUITE 1901
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-1100
Practice Address - Fax:713-790-2643
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2992207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U8378OtherBCBS
TXP00295799OtherRAILROAD MEDICARE
TX116952604Medicaid
TX116952605Medicaid
TXP01037078OtherRR MEDICARE
LA1320480Medicaid
TX116952607Medicaid
TX116952606Medicaid
TX8U8378OtherBLUE CROSS BLUE SHIELD
TXP01402904OtherRR MEDICARE
TX116952608Medicaid
TX335641ZSWDMedicare PIN
TXTXB145689Medicare PIN
TX116952604Medicaid
TXP01402904OtherRR MEDICARE
TX116952605Medicaid
LA1320480Medicaid
TX8F1434Medicare PIN