Organization
GUILLERMO GUARDIOLA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUILLERMO GUARDIOLA CRNA (OWNER)
(817) 294-7444
Entity
Organization
Contact information
Practice address
7451 CHAPEL AVE, FORT WORTH, TX 76116-7090
(817) 294-7444
(817) 294-7172
Mailing address
PO BOX 2626, FORT WORTH, TX 76113-2626
(817) 294-7444
(817) 294-7172
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
659497
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076359
AANA
TX
Enumeration date
11/08/2011
Last updated
11/08/2011
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