MEDICARE: DR. LORI SHYNELL GUIDRY PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1194487991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI SHYNELL GUIDRY PHD

Provider Business Mailing Address
First Line	:	2000 CRAWFORD ST STE 1370
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-9008
Country	:	US
Telephone Number	:	713-344-0703
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 CRAWFORD ST STE 1370
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-9008
Country	:	US
Telephone Number	:	713-344-0703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2021
Last Update Date	:	10/08/2021

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