Healthcare Provider Details
I. General information
NPI: 1760424915
Provider Name (Legal Business Name): SANDRA GUERRA M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/12/2006
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2303 SE MILITARY DR BLDG 528
SAN ANTONIO TX
78223-3542
US
IV. Provider business mailing address
12612 CHALLENGER PKWY STE 365
ORLANDO FL
32826-2784
US
V. Phone/Fax
- Phone: 210-207-8780
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | L0229 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | L0229 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: