Provider Demographics
NPI:1265745335
Name:GUERRA RODRIGUEZ, JONATHAN ADMIL (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ADMIL
Last Name:GUERRA RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7000 NORTH MOPAC
Mailing Address - Street 2:SUITE # 420
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731
Mailing Address - Country:US
Mailing Address - Phone:512-482-0045
Mailing Address - Fax:512-476-9892
Practice Address - Street 1:7000 NORTH MOPAC
Practice Address - Street 2:SUITE # 420
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-482-0045
Practice Address - Fax:512-476-9892
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD12007208M00000X
IDM15019208M00000X
WAMD60784814208M00000X
TXP7452208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX318349YM8AMedicare PIN