Individual provider Active NPI

Bruce Martin Guillory, DC

  • Chiropractor
  • Humble, TX
National Provider Identifier
1235213711
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5554 Issued in TX
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

Updated by the provider on Sep 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
606103OtherTXBCBSH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
05554TXMDClinical Social Worker
5554TXMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.