Provider Demographics
NPI:1548330277
Name:DAVILA, GUADALUPE (MD)
Entity type:Individual
Prefix:DR
First Name:GUADALUPE
Middle Name:
Last Name:DAVILA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S EXPRESSWAY 83 STE B2
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-5909
Mailing Address - Country:US
Mailing Address - Phone:956-406-6285
Mailing Address - Fax:956-406-6300
Practice Address - Street 1:509 S EXPRESSWAY 83 STE B2
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5909
Practice Address - Country:US
Practice Address - Phone:956-406-6285
Practice Address - Fax:956-406-6300
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4783207R00000X
CO46512207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113512106Medicaid
TXTXB126941OtherWELLMED PTAN
CO47579803Medicaid
TX00454DMedicare PIN
COCO300594Medicare PIN