Individual
ANDREA PEDROZA GUEVARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
540 MADISON OAK DR STE 610, SAN ANTONIO, TX 78258-3924
(210) 496-2222
(210) 352-5367
Mailing address
540 MADISON OAK DR STE 610, SAN ANTONIO, TX 78258-3924
(210) 496-2222
(210) 352-5367
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00699
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172670
NBSTSA
TX
01
—
SA00699
LSA LICENSE
TX
Enumeration date
09/19/2018
Last updated
11/07/2018
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