Provider Demographics
NPI:1083089411
Name:MELISSA ODETTE GUERRA
Entity Type:Organization
Organization Name:MELISSA ODETTE GUERRA
Other - Org Name:SOUTH TEXAS FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEIGHTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-987-1466
Mailing Address - Street 1:PO BOX 15268
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-5268
Mailing Address - Country:US
Mailing Address - Phone:956-750-0178
Mailing Address - Fax:
Practice Address - Street 1:910 HIDALGO
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076
Practice Address - Country:US
Practice Address - Phone:956-750-0178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12650111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty