Healthcare Provider Details

I. General information

NPI: 1962091397
Provider Name (Legal Business Name): KRYSTAL L GUERRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 FM 723 RD
RICHMOND TX
77406-9237
US

IV. Provider business mailing address

9211 FM 723 RD
RICHMOND TX
77406-9237
US

V. Phone/Fax

Practice location:
  • Phone: 281-232-5500
  • Fax: 346-239-3500
Mailing address:
  • Phone: 281-232-5500
  • Fax: 346-239-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: