Provider Demographics
NPI:1013303916
Name:DURAN, GUADALUPE (MD)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:DURAN
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 1:7902 E COUNTRY DR APT 426
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-9016
Mailing Address - Country:US
Mailing Address - Phone:917-636-2230
Mailing Address - Fax:
Practice Address - Street 1:1700 E SAUNDERS ST # ED
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5474
Practice Address - Country:US
Practice Address - Phone:956-796-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR6178207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program