Individual
MARLENE DENISE DE LA GUARDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1635 NORTH LOOP WEST, HOUSTON, TX 77008-1593
(713) 400-2990
(713) 400-2993
Mailing address
PO BOX 22926, JACKSON, MS 39225-2926
(713) 400-2990
(713) 400-2993
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
542747
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP104043
TX
367500000X
Certified Registered Nurse Anesthetist
RN542747
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042048
CRNA
—
05
—
170691301
—
TX
05
—
170691302
—
TX
01
—
84378U
BLUE CROSS/BLUE SHIELD
TX
01
—
86162U
BLUE CROSS BLUE SHIELD
TX
01
—
88453U
BCBS - PALLADIUM
TX
01
—
P00198903
RAILROAD MEDICARE
TX
Enumeration date
12/02/2005
Last updated
08/28/2018
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