Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | ||
N | 225C00000X | Rehabilitation Counselor | ||
N | 226300000X | Kinesiotherapist |
NPI | 1073658183 |
---|---|
Provider Name | Mr. Hector Guevara |
First Address | Tyler, TX 75701-8395 |
Second Address | Tyler, TX 75701-8395 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 27/11/2013 |