Provider Demographics
NPI:1427193044
Name:GUARDIOLA, ROGER JR (CSFA)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:
Last Name:GUARDIOLA
Suffix:JR
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 MITCH THOMAS
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4827
Mailing Address - Country:US
Mailing Address - Phone:210-863-8127
Mailing Address - Fax:
Practice Address - Street 1:519 LOW MEADOW DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-2443
Practice Address - Country:US
Practice Address - Phone:210-863-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist