Provider Demographics
NPI:1356400451
Name:GUERRA, DANA D (MS, BS, LPT)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:D
Last Name:GUERRA
Suffix:
Gender:F
Credentials:MS, BS, LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N ED CAREY DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7919
Mailing Address - Country:US
Mailing Address - Phone:956-440-1155
Mailing Address - Fax:956-440-0913
Practice Address - Street 1:801 N ED CAREY DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7919
Practice Address - Country:US
Practice Address - Phone:956-440-1155
Practice Address - Fax:956-440-0913
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1124857174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154838001Medicaid
TX371437270OtherTAX IDENTIFICATION