Provider Demographics
NPI:1851632863
Name:GUERRA, ROEL (RPH)
Entity Type:Individual
Prefix:
First Name:ROEL
Middle Name:
Last Name:GUERRA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 S EXPRESSWAY 83
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-5905
Mailing Address - Country:US
Mailing Address - Phone:956-428-9647
Mailing Address - Fax:956-421-2773
Practice Address - Street 1:613 S EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5905
Practice Address - Country:US
Practice Address - Phone:956-428-9647
Practice Address - Fax:956-421-2773
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist