MEDICARE: ANSELMO A GUERRA CRNA

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	367500000X	Certified Registered Nurse Anesthetist	431182	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750365136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANSELMO A GUERRA CRNA

Provider Business Mailing Address
First Line	:	1010 E WHEATLAND RD
Second Line	:	SUITE A
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4914
Country	:	US
Telephone Number	:	972-283-0063
Fax Number	:	972-283-0284

Provider Business Practice Location Address
First Line	:	7992 W VIRGINIA DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3764
Country	:	US
Telephone Number	:	972-283-2400
Fax Number	:	972-283-0999

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	07/07/2010

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Directions to “ ANSELMO A GUERRA CRNA” Practice Location

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