Provider Demographics
NPI:1013681618
Name:GUZIK, BRENNEN TYLER
Entity Type:Individual
Prefix:
First Name:BRENNEN
Middle Name:TYLER
Last Name:GUZIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7714 LOUIS PASTEUR DR APT 2151
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3531
Mailing Address - Country:US
Mailing Address - Phone:704-500-3335
Mailing Address - Fax:
Practice Address - Street 1:7714 LOUIS PASTEUR DR APT 2151
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3531
Practice Address - Country:US
Practice Address - Phone:704-500-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist