Provider Demographics
NPI:1679882468
Name:GUERRA, JOSHUA JOHN
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JOHN
Last Name:GUERRA
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 1:605 AUSTIN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76701-2050
Mailing Address - Country:US
Mailing Address - Phone:254-203-5711
Mailing Address - Fax:
Practice Address - Street 1:605 AUSTIN AVE STE 1
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-2050
Practice Address - Country:US
Practice Address - Phone:254-203-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80230237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter