Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 12265 | TX |
NPI | 1184059586 |
---|---|
Provider Name | Dr. Toby Michael Guillory JR. |
First Address | Pasadena, TX 77505-3971 |
Second Address | Pasadena, TX 77505-3971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2013 |
Last Update Date | 05/09/2013 |