Provider Demographics
NPI:1447291638
Name:CORTINAS, GUILLERMO A (MD)
Entity type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:A
Last Name:CORTINAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GUILLERMO
Other - Middle Name:A
Other - Last Name:CORTINAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PA
Mailing Address - Street 1:709 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-682-4605
Mailing Address - Fax:956-686-3955
Practice Address - Street 1:709 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-682-4605
Practice Address - Fax:956-686-3955
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0018JEOtherBCBS
00127UMedicare ID - Type Unspecified
G82701Medicare UPIN