Candacie Brahn Guerreiro, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

20977651 Issued in TX

Practice address

1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211

Phone

(940) 322-0771

Fax

(940) 766-4943

NPI assigned

Sep 4, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1588099907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MIDWESTERN PKWY",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763022211",
            "telephone_number": "940-322-0771",
            "fax_number": "940-766-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MIDWESTERN PKWY",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763022211",
            "telephone_number": "940-322-0771",
            "fax_number": "940-766-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERREIRO",
        "first_name": "CANDACIE",
        "middle_name": "BRAHN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "20977651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111408402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jedidiah Grisel, MD
• Mileasha Lyn Grogan
• Franklin Gualtier
• Jessica Gubernath, LVN
• Krystel Marie Gubernath, LVN
• Richard Carr Guess, D.D.S.
• Cari Guidry, D.C.
• Timothy Andrew Guitard, RXM
• Steven D Gulbranson, DDS
• Prashanth Gumpu Shivashankar

• Physical Therapy Assistant in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.