MEDICARE: ELISSA GUERRA DDS

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	122300000X	Dentist	39937	TX

General Provider Information

NPI Number	:	1376329458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISSA GUERRA DDS

Provider Business Mailing Address
First Line	:	410 JOYCE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-2636
Country	:	US
Telephone Number	:	281-908-4784
Fax Number	:

Provider Business Practice Location Address
First Line	:	19507 NORTH FWY STE 522
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-6072
Country	:	US
Telephone Number	:	281-602-0880
Fax Number	:

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

Provider Enumeration Date	:	09/05/2023
Last Update Date	:	09/05/2023

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Directions to “ ELISSA GUERRA DDS” Practice Location

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