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Organization
GUADALUPE EAR, NOSE AND THROAT, PA
Active
Organization
GUADALUPE EAR, NOSE AND THROAT, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER GAYE HENNESSEE M.D. (PRESIDENT)
(830) 379-0299
Entity
Organization
Contact information
Practice address
1414 E WALNUT ST, SEGUIN, TX 78155-5175
(830) 379-0299
(830) 401-0323
Mailing address
PO BOX 1266, SEGUIN, TX 78156-1266
(830) 379-0299
(830) 401-0323
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M1754
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177183401
—
TX
Enumeration date
09/25/2006
Last updated
10/11/2016
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