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NPI Code Detail

MEDICARE: GWENDOLYN ARNETTA GUIDRY MBA

MEDICARE: GWENDOLYN ARNETTA GUIDRY MBA
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)454730TX

General Provider Information

NPI Number : 1366574303
Entity Type Code : Individual
Provider Name (Legal Business Name) : GWENDOLYN ARNETTA GUIDRY MBA
Provider Business Mailing Address
First Line : 4915 MULBERRY CIR
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-4078
Country : US
Telephone Number : 832-310-7796
Fax Number : 832-987-1688
Provider Business Practice Location Address
First Line : 5331 W OREM DR
Second Line :
City : HOUSTON
State : TX
Zip : 77045-5036
Country : US
Telephone Number : 832-310-7796
Fax Number : 832-897-1688
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 05/07/2018

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