Individual provider Active NPI

Marlene Denise De la Guardia, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1689658726
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP104043 Issued in TX
Practice address
1635 North Loop West
Houston, TX 77008-1593
Phone
(713) 400-2990
Fax
(713) 400-2993
NPI assigned
Dec 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 542747 TX
Certified Registered Nurse Anesthetist 367500000X RN542747 TX
Certified Registered Nurse Anesthetist 367500000X AP104043 TX Primary

Addresses

Primary practice location

1635 North Loop West
Houston, TX 77008-1593

Mailing address

PO Box 22926
Jackson, MS 39225-2926
Phone (713) 400-2990

Other identifiers 7

IdentifierTypeStateIssuer
170691301MedicaidTX
84378UOtherTXBLUE CROSS/BLUE SHIELD
042048OtherCRNA
88453UOtherTXBCBS - PALLADIUM
P00198903OtherTXRAILROAD MEDICARE
86162UOtherTXBLUE CROSS BLUE SHIELD
170691302MedicaidTX

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN542747TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesia Associates PA PastSince May 1, 2017 Accepting new patients
Medical Center Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
River Oaks Anesthesia Consultants PA Past Accepting new patients
Texas Anesthesiology Consultants of Houston PA Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1689658726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22926",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392252926",
            "telephone_number": "713-400-2990",
            "fax_number": "713-400-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 NORTH LOOP WEST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081593",
            "telephone_number": "713-400-2990",
            "fax_number": "713-400-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA GUARDIA",
        "first_name": "MARLENE",
        "middle_name": "DENISE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "542747",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "RN542747",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP104043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170691301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "84378U",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA",
            "identifier": "042048",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - PALLADIUM",
            "identifier": "88453U",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00198903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "86162U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170691302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.