Provider Demographics
NPI:1922008697
Name:GUERRA, IRIS YANIRA (PA)
Entity Type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:YANIRA
Last Name:GUERRA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-3803
Mailing Address - Country:US
Mailing Address - Phone:956-488-1200
Mailing Address - Fax:956-488-9500
Practice Address - Street 1:201 E 2ND ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3803
Practice Address - Country:US
Practice Address - Phone:956-488-1200
Practice Address - Fax:956-488-9500
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03933363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant