Provider Demographics
NPI:1457351777
Name:ECHEVERRI, LUIS GUILLERMO (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:GUILLERMO
Last Name:ECHEVERRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7737 SOUTHWEST FWY
Mailing Address - Street 2:STE 201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1819
Mailing Address - Country:US
Mailing Address - Phone:713-790-5227
Mailing Address - Fax:713-790-5505
Practice Address - Street 1:TEXAS SURGICAL ASSOCIATES
Practice Address - Street 2:7737 SOUTHWEST FREEWAY, SUITE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1819
Practice Address - Country:US
Practice Address - Phone:713-776-3402
Practice Address - Fax:713-776-1069
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2019-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK2453208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1297251-06Medicaid
TX8A6472OtherBCBS
TX1297251-06Medicaid
TX8199K5Medicare PIN