| Doctor Name: | VIDAL GUEVARA |
| NPI Number: | 1063528909 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., LPC-S, LSSP |
| License Number: | 14262 |
| Business Practice Address: | 2002 Commerce St Suite C Victoria, TX - 779015510 |
| Business Phone Number: | 3615701444 |
| Business Fax Number: | |
| Mailing Address: | 2002 Commerce St, Suite C VICTORIA |
| State: | TX |
| Postal Code: | 779015510 |
| Phone Number: | 3615701444 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 14262 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |