MEDICARE: LILLY GUIDRY

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	101YM0800X	Mental Health Counselor	100043	TX
2	101YP2500X	Professional Counselor	100043	TX

General Provider Information

NPI Number	:	1366397887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLY GUIDRY

Provider Business Mailing Address
First Line	:	1067 FM 306 STE 402
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-6895
Country	:	US
Telephone Number	:	830-312-7921
Fax Number	:	830-629-2700

Provider Business Practice Location Address
First Line	:	10330 LAKE RD STE M
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-1886
Country	:	US
Telephone Number	:	830-312-7921
Fax Number	:	830-629-2700

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ LILLY GUIDRY ” Practice Location

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