Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 16271 | TX |
N | 1223D0001X | Dental Public Health | 10761 | TX |
NPI | 1033244371 |
---|---|
Provider Name | Gary Peter Guillory |
First Address | Somerset, TX 78069 |
Second Address | Somerset, TX 78069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |