Provider Demographics
NPI:1083214449
Name:GUERRERO, JAMIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 E INTERSTATE 20
Mailing Address - Street 2:
Mailing Address - City:HUDSON OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76087-8596
Mailing Address - Country:US
Mailing Address - Phone:817-599-3750
Mailing Address - Fax:817-599-9884
Practice Address - Street 1:2801 E INTERSTATE 20
Practice Address - Street 2:
Practice Address - City:HUDSON OAKS
Practice Address - State:TX
Practice Address - Zip Code:76087-8596
Practice Address - Country:US
Practice Address - Phone:817-599-3750
Practice Address - Fax:817-599-9884
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist