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General NPI Number Information
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NPI Number | 1992934905
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Entity Type | Organization
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Legal Business Name | CHARLES JOSEPH GUIDRY JR
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Dates
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Enumeration Date | 07/11/2009
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 9000 SOUTHWEST FWY 400
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City | HOUSTON
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State | TX
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Zip | 77074-1526
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Country | US
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Telephone | 713-270-1541
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Fax | 713-270-7999
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Provider Business Mailing Address
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Address Line | 9000 SOUTHWEST FWY 400
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City | HOUSTON
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State | TX
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Zip | 77074-1526
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Country | US
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Telephone | 713-270-1541
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Fax | 713-270-7999
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHARLES JOSEPH GUIDRY JR.
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Credential | LBSW
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Telephone | 713-270-1541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | N37435
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | N37435
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License Number State | TX
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