Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | P0727 | TX |
NPI | 1336346535 |
---|---|
Provider Name | Dr. Charles Walker Guy II |
First Address | Killeen, TX 76548-7469 |
Second Address | Waco, TX 76712-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 01/11/2018 |