Healthcare Provider Details

I. General information

NPI: 1376793380
Provider Name (Legal Business Name): SONIA GUERRA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 FALLBROOK DR SUITE 304
HOUSTON TX
77065-4237
US

IV. Provider business mailing address

13100 NORTHWEST FWY SUITE 400
HOUSTON TX
77040-6310
US

V. Phone/Fax

Practice location:
  • Phone: 832-237-3500
  • Fax: 832-237-0200
Mailing address:
  • Phone: 832-237-3500
  • Fax: 832-237-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number699456
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: