Active NPI
Bruce Martin Guillory, DC
- Chiropractor
- Humble, TX
National Provider Identifier
1235213711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5554
- Practice address
- 18477 West Lake Houston Pkwy
Ste 70
Humble, TX 77346 - Phone
- (281) 852-5600
- Fax
- (281) 852-5613
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5554 | TX | Primary |
Addresses
Primary practice location
18477 West Lake Houston Pkwy
Ste 70
Humble, TX 77346
Mailing address
18477 West Lake Houston Pkwy
Ste 70
Humble, TX 77346
Phone (281) 852-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 606103 | Other | TX | BCBSH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070312000065 | TX | Practitioner - Chiropractic | 1153424296 | Practice locations: Humble, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
18477 W Lake Houston Pkwy
Suite 70
Humble, TX 77346-3643
Phone (281) 852-5600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05554 | TX | MD | Clinical Social Worker |
| 5554 | TX | MD | Veterinarian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Lake Houston Chiropractic Center, Inc. | Chiropractor | Past | Accepting new patients |
| Davenport Chiropractic, Inc. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Humble, TX
- NPI 1063665206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1235213711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18477 WEST LAKE HOUSTON PKWY",
"address_2": "STE 70",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77346",
"telephone_number": "281-852-5600",
"fax_number": "281-852-5613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18477 WEST LAKE HOUSTON PKWY",
"address_2": "STE 70",
"city": "HUMBLE",
"state": "TX",
"postal_code": "77346",
"telephone_number": "281-852-5600",
"fax_number": "281-852-5613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUILLORY",
"first_name": "BRUCE",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "5554",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSH",
"identifier": "606103",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.