Basic Information
| Provider Information | |||||||||
| NPI: | 1821024019 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORRE | ||||||||
| FirstName: | GUILLERMO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SMITH TOWER, SUITE 1901 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134411100 | ||||||||
| FaxNumber: | 7137902643 | ||||||||
| Practice Location | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SMITH TOWER, SUITE 1901 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134411100 | ||||||||
| FaxNumber: | 7137902643 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 02/27/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | J2992 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | J2992 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 8U8378 | 01 | TX | BCBS | OTHER | P00295799 | 01 | TX | RAILROAD MEDICARE | OTHER | 116952604 | 05 | TX | MEDICAID | 116952605 | 05 | TX | MEDICAID | P01037078 | 01 | TX | RR MEDICARE | OTHER | 1320480 | 05 | LA | MEDICAID | 116952607 | 05 | TX | MEDICAID | 116952606 | 05 | TX | MEDICAID | 8U8378 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | P01402904 | 01 | TX | RR MEDICARE | OTHER | 116952608 | 05 | TX | MEDICAID |