Provider Demographics
NPI:1891036653
Name:GUERRERO, AGLAEE BERENICE (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:AGLAEE
Middle Name:BERENICE
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5664
Mailing Address - Country:US
Mailing Address - Phone:956-380-6219
Mailing Address - Fax:
Practice Address - Street 1:1212 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5664
Practice Address - Country:US
Practice Address - Phone:956-380-6219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist