MEDICARE: DR. ADRIANA GUERRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036.117278	IL
2	207Q00000X	Family Medicine Physician	N3132	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00758159	OTHER	TX	RRMCR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104029735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIANA GUERRA M.D.

Provider Business Mailing Address
First Line	:	2301 W. NORTH LOOP BLVD.
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756
Country	:	US
Telephone Number	:	512-452-2506
Fax Number	:	512-824-0152

Provider Business Practice Location Address
First Line	:	2301 W. NORTH LOOP BLVD.
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756
Country	:	US
Telephone Number	:	512-452-2506
Fax Number	:	512-824-0152

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2007
Last Update Date	:	11/26/2013

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