MEDICARE: JAIDAH GUILLORY

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	106S00000X	Behavior Technician		TX

General Provider Information

NPI Number	:	1942168588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIDAH GUILLORY

Provider Business Mailing Address
First Line	:	7100 OLD KATY RD APT 4312
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2294
Country	:	US
Telephone Number	:	281-721-3553
Fax Number	:

Provider Business Practice Location Address
First Line	:	4722 RIVERSTONE BLVD STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4723
Country	:	US
Telephone Number	:	817-984-8655
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ JAIDAH GUILLORY ” Practice Location

Language	Start Address	Practice Location

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