Provider Demographics
NPI:1073609418
Name:GUERRERO-TIRO, LOURDES M (MD)
Entity Type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:M
Last Name:GUERRERO-TIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LOURDES
Other - Middle Name:MALVEDA
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:BUILDING 2108, SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-512-8029
Mailing Address - Fax:602-512-8161
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:MAIN BUILDING
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-3366
Practice Address - Fax:602-933-4166
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ210952080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD89932Medicare UPIN