Individual provider Active NPI

Thomas S Guillot, M.D.

  • Specialist
  • Houston, TX
National Provider Identifier
1336147925
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD.015270 Issued in LA
Practice address
11914 Astoria Blvd
Suite 470
Houston, TX 77089-6064
Phone
(281) 484-0088
NPI assigned
Jul 8, 2005
Reactivated
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD.015270 LA Primary

Addresses

Primary practice location

11914 Astoria Blvd
Suite 470
Houston, TX 77089-6064

Mailing address

11914 Astoria Blvd
Suite 470
Houston, TX 77089-6064
Phone (281) 484-0088

Other identifiers 1

IdentifierTypeStateIssuer
1323543MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000178 LA Practitioner - Emergency Medicine 6507830791 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.015270LAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
C & M Medical Services, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Povilas Vitenas Jr MD Specialist Past Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

301 Walnut St
Amite, LA 70422
Phone (985) 748-7141

2202 False River Dr
New Roads, LA 70760
Phone (225) 638-5702

Organizations & group practices 3

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1336147925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11914 ASTORIA BLVD",
            "address_2": "SUITE 470",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896064",
            "telephone_number": "281-484-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11914 ASTORIA BLVD",
            "address_2": "SUITE 470",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896064",
            "telephone_number": "281-484-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLOT",
        "first_name": "THOMAS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-10-03",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "MD.015270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1323543",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.