Individual
JASON SOLITA DE GUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
12717 INTERSTATE 45 N STE 300, WILLIS, TX 77318-7035
(936) 228-7598
Mailing address
1931 GOLDEN CAPE DR, KATY, TX 77494-7745
(650) 451-2290
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP142324
TX
363LF0000X
Family Nurse Practitioner
AP142324
TX
Other
Enumeration date
04/30/2020
Last updated
09/13/2021
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