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General NPI Number Information
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NPI Number | 1285864066
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Entity Type | Individual
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Provider Name | NICOLAS NOEL GUERRA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2009
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 19238 STONEHUE
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3447
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Country | US
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Telephone | 210-494-2223
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Fax | 210-494-6516
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Provider Business Mailing Address
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Address Line | 19238 STONEHUE
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3447
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Country | US
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Telephone | 210-494-2223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | N3060
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License Number State | TX
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