Active NPI
Lisa Maricela Guerra
- Speech-Language Pathologist
- San Antonio, TX
National Provider Identifier
1174777197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 101614
- Practice address
- 4207 Gardendale St # 106
San Antonio, TX 78229-3182 - Phone
- (210) 692-0222
- NPI assigned
- Nov 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 101614 | TX | Primary |
Addresses
Primary practice location
4207 Gardendale St # 106
San Antonio, TX 78229-3182
Mailing address
2823 Lakehills St
San Antonio, TX 78251-1718
Phone (210) 692-0222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174777197 | Other | TX | NPI# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101614 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240358400000",
"number": "1174777197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2823 LAKEHILLS ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782511718",
"telephone_number": "210-692-0222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4207 GARDENDALE ST # 106",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293182",
"telephone_number": "210-692-0222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRA",
"first_name": "LISA",
"middle_name": "MARICELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-05",
"last_updated": "2009-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "101614",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI#",
"identifier": "1174777197",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.