Provider Demographics
NPI:1689721672
Name:GUARDIA, RENE W (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:W
Last Name:GUARDIA
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 1:525 S MASON RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2491
Mailing Address - Country:US
Mailing Address - Phone:281-599-1533
Mailing Address - Fax:281-599-1883
Practice Address - Street 1:525 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2491
Practice Address - Country:US
Practice Address - Phone:281-599-1533
Practice Address - Fax:281-599-1883
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8067208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics