Provider Demographics
NPI:1023200623
Name:GUERRA, DIANA M (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:M
Last Name:GUERRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16651 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2345
Mailing Address - Country:US
Mailing Address - Phone:281-276-0827
Mailing Address - Fax:281-275-0760
Practice Address - Street 1:16651 SOUTHWEST FWY
Practice Address - Street 2:SUITE 450
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2345
Practice Address - Country:US
Practice Address - Phone:281-276-0827
Practice Address - Fax:281-275-0760
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2864207L00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX299091308Medicaid
TX8FT835OtherBLUE CROSS BLUE SHIELD
TX299091308Medicaid