Provider Demographics
NPI:1568777829
Name:GUERRA- WATSON AND ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:GUERRA- WATSON AND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA-WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-416-1235
Mailing Address - Street 1:1701 W NORTHWEST HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8145
Mailing Address - Country:US
Mailing Address - Phone:817-416-1235
Mailing Address - Fax:
Practice Address - Street 1:1701 W NORTHWEST HWY STE 100
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8145
Practice Address - Country:US
Practice Address - Phone:817-416-1235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31889103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty