Individual
MICHAEL B GUILLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3209 N 4TH ST, SUITE 100, LONGVIEW, TX 75605-5145
(903) 757-4662
(903) 757-4665
Mailing address
3209 N 4TH ST, SUITE 100, LONGVIEW, TX 75605-5145
(903) 757-4662
(903) 757-4665
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
F2271
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089523702
—
TX
01
—
2223181
BLUE LINK
TX
01
—
826081717
RAIL ROAD MEDICARE
TX
Enumeration date
07/06/2006
Last updated
09/23/2010
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