Provider Demographics
NPI:1053440388
Name:GUERRERO, ROBERTO GUADALUPE (LICAC DIPLOM)
Entity type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:GUADALUPE
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:LICAC DIPLOM
Other - Prefix:
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Mailing Address - Street 1:215 SWEET
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204-1532
Mailing Address - Country:US
Mailing Address - Phone:210-874-6617
Mailing Address - Fax:210-783-9343
Practice Address - Street 1:14603 HUEBNER RD STE 2602
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5495
Practice Address - Country:US
Practice Address - Phone:210-870-3980
Practice Address - Fax:210-783-9343
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00954171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist