Basic Information
| Provider Information | |||||||||
| NPI: | 1619958204 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUIDO | ||||||||
| FirstName: | ERNESTO | ||||||||
| MiddleName: | HUGO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5920 SARATOGA BLVD | ||||||||
| Address2: | STE 540 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784144103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3619948883 | ||||||||
| FaxNumber: | 3619949456 | ||||||||
| Practice Location | |||||||||
| Address1: | 7121 S PADRE ISLAND DR | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784124938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3616966200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | E7099 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 113383704 | 05 | TX | MEDICAID | 1N0014 | 01 | TX | MEDICARE | OTHER |