MEDICARE: DR. RICHARD I. GUIDRY JR. D.C.

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	111N00000X	Chiropractor	8045	TX

General Provider Information

NPI Number	:	1336286657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD I. GUIDRY JR. D.C.

Provider Business Mailing Address
First Line	:	2825 WILCREST DR
Second Line	:	#607
City	:	HOUSTON
State	:	TX
Zip	:	77042-3391
Country	:	US
Telephone Number	:	713-780-0788
Fax Number	:	713-975-1717

Provider Business Practice Location Address
First Line	:	2825 WILCREST DR
Second Line	:	#607
City	:	HOUSTON
State	:	TX
Zip	:	77042-3391
Country	:	US
Telephone Number	:	713-780-0788
Fax Number	:	713-975-1717

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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