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NPI Code Detail

MEDICARE: ANDREA BORBON GUEVARA

MEDICARE: ANDREA BORBON GUEVARA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian6148AL

General Provider Information

NPI Number : 1043145543
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA BORBON GUEVARA
Provider Business Mailing Address
First Line : 3724 JEFFERSON ST STE 104
Second Line :
City : AUSTIN
State : TX
Zip : 78731-6204
Country : US
Telephone Number : 256-466-6422
Fax Number :
Provider Business Practice Location Address
First Line : 3724 JEFFERSON ST STE 104
Second Line :
City : AUSTIN
State : TX
Zip : 78731-6204
Country : US
Telephone Number : 256-466-6422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ ANDREA BORBON GUEVARA ” Practice Location

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