Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | P2864 | TX |
Y | 207RC0200X | Critical Care Medicine | P2864 | TX |
N | 207RP1001X | Pulmonary Disease | P2864 | TX |
NPI | 1023200623 |
---|---|
Provider Name | Diana M. Guerra |
First Address | Sugar Land, TX 77479-2345 |
Second Address | Sugar Land, TX 77479-2345 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 13/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
299091308 | (05) | TX |
8FT835 | BLUE CROSS BLUE SHIELD (01) | TX |