Healthcare Provider Details

I. General information

NPI: 1528539426
Provider Name (Legal Business Name): ANASTASHIA N GUILLORY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 UNIVERSITY BLVD
GALVESTON TX
77555-0001
US

IV. Provider business mailing address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

V. Phone/Fax

Practice location:
  • Phone: 409-772-2222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1059969
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: