Mary Lorraine Guy-Dial

Individual provider Active NPI Other Technician · Whitehouse, TX

NPI 1194010413 · NPPES record last updated Aug 28, 2024

Key facts

NPI
1194010413
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
411 Gatewood Dr
Whitehouse, TX 75791-3325
Phone
(903) 714-4544
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

411 Gatewood Dr
Whitehouse, TX 75791-3325

Mailing address

411 Gatewood Dr
Whitehouse, TX 75791-3325
Phone (903) 714-4544

Other providers in Whitehouse, TX

All providers in Whitehouse, TX · Other Technician in Texas

Sources for this page

Verify at the official NPI Registry.