Provider Demographics
NPI:1891276986
Name:GUERRERO, JORGE
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:GUERRERO
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 1:1313 E ALTON GLOOR BLVD STE I
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3911
Mailing Address - Country:US
Mailing Address - Phone:985-714-1630
Mailing Address - Fax:
Practice Address - Street 1:2448 HAMBURG ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-3816
Practice Address - Country:US
Practice Address - Phone:985-714-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care