Provider Demographics
NPI:1487257283
Name:SEGURA GUERRA, FRANCISCO
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:SEGURA GUERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 POINT SUCCESS AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7885
Mailing Address - Country:US
Mailing Address - Phone:323-383-5042
Mailing Address - Fax:
Practice Address - Street 1:1147 POINT SUCCESS AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7885
Practice Address - Country:US
Practice Address - Phone:323-383-5042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3013225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty