Basic Information
Provider Information
NPI: 1750329066
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUERRA
FirstName: RICARDO
MiddleName:  
NamePrefix: DR.
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8440 WALNUT HILL LN
Address2: SUITE 700
City: DALLAS
State: TX
PostalCode: 752313833
CountryCode: US
TelephoneNumber: 2143613300
FaxNumber: 2143613431
Practice Location
Address1: 4510 MEDICAL CENTER DR STE 108
Address2:  
City: MCKINNEY
State: TX
PostalCode: 750691624
CountryCode: US
TelephoneNumber: 2147269292
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/02/2006
LastUpdateDate: 01/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0011XL9221TXY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

ID Information
IDTypeStateIssuerDescription
8P581001TXBCBSOTHER
17800170105TX MEDICAID


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