Individual
GUILLERMO GUARDIOLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12222 MERIT DR STE 600, DALLAS, TX 75251-3294
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
659497
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP116503
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192909301
—
TX
01
—
88822U
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/07/2008
Last updated
07/08/2022
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