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NPI Code Detail

MEDICARE: GERARD GUIDRY M.D.

MEDICARE: GERARD GUIDRY M.D.
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
1207W00000XOphthalmology Physician020598LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MD.020598OTHERLASTATE LICENSE

General Provider Information

NPI Number : 1235198599
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARD GUIDRY M.D.
Provider Business Mailing Address
First Line : PO BOX 122108 DEPT 2108
Second Line :
City : DALLAS
State : TX
Zip : 75312-0001
Country : US
Telephone Number : 337-494-2921
Fax Number : 337-494-6523
Provider Business Practice Location Address
First Line : 1000 WALTERS ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70607-4647
Country : US
Telephone Number : 337-480-8066
Fax Number : 337-480-8061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 04/27/2022

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