Individual
DR. GUOFAN XU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
R5339
TX
207UN0902X
Nuclear Imaging & Therapy Physician
A130001
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379460401
—
TX
01
—
379460402
MEDICAID CSHCN
TX
Enumeration date
08/15/2012
Last updated
03/05/2018
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