Provider Demographics
NPI:1427215813
Name:CARLOS GUERRA JR MD PA
Entity Type:Organization
Organization Name:CARLOS GUERRA JR MD PA
Other - Org Name:CARLOS GUERRA JR MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-840-7956
Mailing Address - Street 1:9701 RICHMOND
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042
Mailing Address - Country:US
Mailing Address - Phone:713-840-7956
Mailing Address - Fax:713-840-7957
Practice Address - Street 1:9701 RICHMOND
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042
Practice Address - Country:US
Practice Address - Phone:713-840-7956
Practice Address - Fax:713-840-7957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH80942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4632139OtherAETNA
TX8B4250OtherBCBS
TXP1822411OtherOXFORD UNITED BEHAVIORAL HEALTH
TX10016364Medicaid
TX022235OtherVALUE OPTIONS
TX115402302Medicaid
TX699552OtherCOMPSYCH
TX115402302Medicaid