Organization · NPI-2

Michael B. Guillory, MD., P.A.

Ophthalmology · Longview, TX

NPI number1619084258
StatusActive
Last updated in NPPESApr 29, 2024

Details

NPI
1619084258
Entity type
Organization (NPI-2)
Legal business name
Michael B. Guillory, MD., P.A.
Organization subpart
No
Enumeration date
Aug 23, 2006
Certification date
Apr 29, 2024
Last updated
Apr 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X OphthalmologyF2271TXYes

Practice location

3209 N 4th St
Suite 100
Longview, TX 75605-5145

Phone 903-757-4662

Mailing address

3209 N 4th St
Suite 100
Longview, TX 75605-5145

Phone 903-757-4662

Authorized official

Michael B Guillory
President
9037574662

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