Provider Demographics
NPI:1477652345
Name:GUERRERO, RODOLFO (MD)
Entity Type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 E 8TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6638
Mailing Address - Country:US
Mailing Address - Phone:956-968-2117
Mailing Address - Fax:956-968-8287
Practice Address - Street 1:1402 E 8TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6638
Practice Address - Country:US
Practice Address - Phone:956-968-2117
Practice Address - Fax:956-968-8287
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE43722086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0997140-01Medicaid
TXC16373Medicare UPIN
TX0997140-01Medicaid