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Individual

ITINA GUIDRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15011 MONRAD DR, HOUSTON, TX 77053-1344
(832) 276-9238
Mailing address
614 SHADY DALE DR, STAFFORD, TX 77477-5925
(832) 276-9238

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
172V00000X
Community Health Worker
Primary
246RM2200X
Medical Laboratory Technician
165268
TX

Other

Enumeration date
09/10/2009
Last updated
09/11/2009
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