MEDICARE: BIANCA GUERRA PT

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	225100000X	Physical Therapist	1011310	TX

General Provider Information

NPI Number	:	1629373931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA GUERRA PT

Provider Business Mailing Address
First Line	:	2140 BABCOCK RD
Second Line	:	SUITE 130
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4424
Country	:	US
Telephone Number	:	210-614-7953
Fax Number	:	210-614-4190

Provider Business Practice Location Address
First Line	:	2140 BABCOCK RD
Second Line	:	SUITE 130
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4424
Country	:	US
Telephone Number	:	210-614-7953
Fax Number	:	210-614-4190

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

Provider Enumeration Date	:	01/18/2011
Last Update Date	:	01/18/2011

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Directions to “ BIANCA GUERRA PT” Practice Location

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