Provider Demographics
NPI:1386207280
Name:GUERRA, JORDAN LEE (PA)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:LEE
Last Name:GUERRA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-8383
Mailing Address - Fax:956-362-8382
Practice Address - Street 1:1601 E SPRAGUE ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-5260
Practice Address - Country:US
Practice Address - Phone:956-362-8383
Practice Address - Fax:956-362-8382
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA12789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant