Provider Demographics
NPI:1376825703
Name:GUERRERO, JUDITH (DPT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10609 IH 10 W
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1672
Mailing Address - Country:US
Mailing Address - Phone:210-344-5437
Mailing Address - Fax:210-344-5535
Practice Address - Street 1:10609 IH 10 W
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1672
Practice Address - Country:US
Practice Address - Phone:210-344-5437
Practice Address - Fax:210-344-5535
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12084132251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics