Provider Demographics
NPI:1962364588
Name:GUERRA, MATTHEW ISAIAH (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ISAIAH
Last Name:GUERRA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 NICKEL AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-7850
Mailing Address - Country:US
Mailing Address - Phone:956-994-8880
Mailing Address - Fax:956-517-1481
Practice Address - Street 1:5413 N 23RD ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4082
Practice Address - Country:US
Practice Address - Phone:956-994-8880
Practice Address - Fax:956-517-1481
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1407682225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist