Provider Demographics
NPI:1538112198
Name:GUERRA, LUIS G (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:G
Last Name:GUERRA
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:PO BOX 360557
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6557
Mailing Address - Country:US
Mailing Address - Phone:915-444-5460
Mailing Address - Fax:915-225-3745
Practice Address - Street 1:550 S MESA HILLS DR STE C3
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5765
Practice Address - Country:US
Practice Address - Phone:915-444-5460
Practice Address - Fax:915-225-3745
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1S3697OtherMEDICARE
TX123562401Medicaid
TX00L58WMedicare ID - Type Unspecified