Basic Information
Provider Information
NPI: 1023085891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GURIAN
FirstName: JOHN
MiddleName: H.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8401 DATAPOINT DR
Address2: SUITE 600
City: SAN ANTONIO
State: TX
PostalCode: 782295900
CountryCode: US
TelephoneNumber: 2106167700
FaxNumber: 2106167709
Practice Location
Address1: 8401 DATAPOINT DR
Address2: SUITE 600
City: SAN ANTONIO
State: TX
PostalCode: 782295900
CountryCode: US
TelephoneNumber: 2106167700
FaxNumber: 2106167709
Other Information
ProviderEnumerationDate: 03/01/2006
LastUpdateDate: 03/31/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085N0700XJ9071TXN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085R0202XJ9071TXY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
J907101TXTEXAS MEDICAL LICENSEOTHER
13581370805TX MEDICAID
13581370905TX MEDICAID
13581370701TXCSHCNOTHER


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