Provider Demographics
NPI:1518744002
Name:GUARDADO, ROGELIO
Entity Type:Individual
Prefix:
First Name:ROGELIO
Middle Name:
Last Name:GUARDADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5732 MARY FRANCIS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-3936
Mailing Address - Country:US
Mailing Address - Phone:183-220-8775
Mailing Address - Fax:
Practice Address - Street 1:5732 MARY FRANCIS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-3936
Practice Address - Country:US
Practice Address - Phone:183-220-8775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator