Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125062392 | IL |
Y | 2080P0214X | Pediatric Pulmonologist | R9549 | TX |
NPI | 1447505409 |
---|---|
Provider Name | Maria Victoria Talamo Guevara |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 06/04/2021 |