MEDICARE: KAITH MERLIN ANNE GUINTU

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	363A00000X	Physician Assistant	PA17436	TX

General Provider Information

NPI Number	:	1932742558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITH MERLIN ANNE GUINTU

Provider Business Mailing Address
First Line	:	PO BOX 844658 2401 S 31ST ST MS -AR-M200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4658
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 HILLCREST MEDICAL BLVD
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712-8897
Country	:	US
Telephone Number	:	254-724-2111
Fax Number	:

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

Provider Enumeration Date	:	10/27/2019
Last Update Date	:	12/21/2025

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Directions to “ KAITH MERLIN ANNE GUINTU ” Practice Location

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