Healthcare Provider Details

I. General information

NPI: 1922917475
Provider Name (Legal Business Name): JOSHUA DOMINIC GUERRA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6914 BRISBANE CT STE 200
SUGAR LAND TX
77479-4924
US

IV. Provider business mailing address

6914 BRISBANE COURT, SUITE 200, SUGAR LAND TX 77479
SAN ANTONIO TX
78214-1529
US

V. Phone/Fax

Practice location:
  • Phone: 844-272-7223
  • Fax:
Mailing address:
  • Phone: 210-790-2504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: