Provider Demographics
NPI:1538480868
Name:GUERRA, TERESA (EDD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:GUERRA
Suffix:
Gender:F
Credentials:EDD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 KATIE HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-4839
Mailing Address - Country:US
Mailing Address - Phone:346-955-8123
Mailing Address - Fax:
Practice Address - Street 1:3920 MICKEY GILLEY BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3005
Practice Address - Country:US
Practice Address - Phone:346-955-8123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103603235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX76-0693728OtherEMPLOYER IDENTIFICATION NUMBER