Provider Demographics
NPI:1316305923
Name:GUERRERO, ANNA MARIE (RD)
Entity type:Individual
Prefix:
First Name:ANNA MARIE
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:1611 N ALAMO ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1381
Mailing Address - Country:US
Mailing Address - Phone:210-333-0733
Mailing Address - Fax:210-333-0763
Practice Address - Street 1:1611 N ALAMO ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1381
Practice Address - Country:US
Practice Address - Phone:210-333-0733
Practice Address - Fax:210-333-0763
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06442133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered