Provider Demographics
NPI:1013953389
Name:GUERRA, CARLOS JR (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:GUERRA
Suffix:JR
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 1:9701 RICHMOND AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4633
Mailing Address - Country:US
Mailing Address - Phone:832-767-2522
Mailing Address - Fax:832-767-2522
Practice Address - Street 1:9701 RICHMOND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4633
Practice Address - Country:US
Practice Address - Phone:832-767-2522
Practice Address - Fax:832-767-2522
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH80942084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1154023-01Medicaid
TXE83471Medicare UPIN
TX8B4250Medicare ID - Type Unspecified