MEDICARE: DR. JOSEPH MANUEL GUILEYARDO M.D.

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	207ZF0201X	Forensic Pathology Physician	H7750	TX
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	H7750	TX

General Provider Information

NPI Number	:	1568420396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MANUEL GUILEYARDO M.D.

Provider Business Mailing Address
First Line	:	2911 TURTLE CREEK BLVD
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75219-6223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 TURTLE CREEK BLVD
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75219-6223
Country	:	US
Telephone Number	:	214-942-0250
Fax Number	:

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	07/15/2007

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