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NPI Code Detail

MEDICARE: HEATHER M GUILLOT MD

MEDICARE:   HEATHER M GUILLOT  MD
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
1207Q00000XFamily Medicine Physician026099LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689684144
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER M GUILLOT MD
Provider Business Mailing Address
First Line : 919 HIDDEN RDG
Second Line :
City : IRVING
State : TX
Zip : 75038-3813
Country : US
Telephone Number : 469-282-2711
Fax Number : 469-282-2609
Provider Business Practice Location Address
First Line : 3704 NORTH BLVD STE D
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3658
Country : US
Telephone Number : 318-528-3200
Fax Number : 318-528-3201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 01/16/2017

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Directions to “ HEATHER M GUILLOT MD” Practice Location

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