Basic Information
| Provider Information | |||||||||
| NPI: | 1629373931 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUERRA | ||||||||
| FirstName: | BIANCA | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2140 BABCOCK RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782294424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106147953 | ||||||||
| FaxNumber: | 2106144190 | ||||||||
| Practice Location | |||||||||
| Address1: | 2140 BABCOCK RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782294424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106147953 | ||||||||
| FaxNumber: | 2106144190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2011 | ||||||||
| LastUpdateDate: | 01/18/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1011310 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.