Individual
KELLY J GUESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
516893
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002418403
—
TX
05
—
002418404
—
TX
01
—
85614U
BLUE CROSS BLUE SHIELD
TX
01
—
89681U
BCBS
TX
Enumeration date
09/02/2006
Last updated
06/20/2018
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