Rene Guardiola, SURGICAL ASSISTANT
Individual provider Active NPI Surgical Assistant · Somerset, TX
NPI 1639415151 · NPPES record last updated Oct 28, 2016
Key facts
- NPI
- 1639415151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Assistant 246ZC0007X
- License
- 12-217 (TX)
- Practice address
- 21026 Somerset Rd Unit 2
Somerset, TX 78069-3380 - Phone
- (210) 313-1452
- NPI assigned
- Jan 2, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12-217 | TX | MD | Surgical Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 12-217 | TX | Yes |
Addresses
Primary practice location
21026 Somerset Rd Unit 2
Somerset, TX 78069-3380
Mailing address
21026 Somerset Rd Unit 2
Somerset, TX 78069-3380
Phone (210) 313-1452
Other providers in Somerset, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.