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Individual
GUILLERMO MARTIN FUENTES
Active
Individual
GUILLERMO MARTIN FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K8749
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039181502
TPI
TX
01
—
10031886
AMERIGROUP
TX
05
—
147634301
—
TX
01
—
7327110
AETNA ID
TX
01
—
8F0700
BLUECROSSBLUESHIELD
TX
01
—
9818
PARKLAND ID
TX
01
—
K8749
TX-LICENSE
TX
Enumeration date
10/06/2006
Last updated
03/16/2009
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