Provider Demographics
NPI:1871231001
Name:PORRAS GURIDI, MAURICIO (DPT)
Entity Type:Individual
Prefix:
First Name:MAURICIO
Middle Name:
Last Name:PORRAS GURIDI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 KANSAS ST STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-1145
Mailing Address - Country:US
Mailing Address - Phone:281-682-4704
Mailing Address - Fax:
Practice Address - Street 1:4009 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6817
Practice Address - Country:US
Practice Address - Phone:713-529-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1360129225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist