Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | K9276 | TX |
N | 207RX0202X | Medical Oncology | MD-060834-L | PA |
NPI | 1013078294 |
---|---|
Provider Name | Guillermo Garcia-Manero |
First Address | Houston, TX 77030-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 26/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103569301 | (05) | TX |
88798X | BCBS (01) | TX |
G97878 | (02) |