Provider Demographics
NPI:1114775863
Name:GUERRA, FERNANDO (DC)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
Last Name:GUERRA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 TREY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2445
Mailing Address - Country:US
Mailing Address - Phone:956-450-7033
Mailing Address - Fax:
Practice Address - Street 1:1311 TREY DR STE 2
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2445
Practice Address - Country:US
Practice Address - Phone:956-450-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor