NPIMap

Organization Active NPI

Guadalupe Ear, Nose and Throat, PA

  • Otolaryngology Physician
  • Seguin, TX
National Provider Identifier
1558461855
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
M1754 Issued in TX
Legal business name
GUADALUPE EAR, NOSE AND THROAT, PA
Practice address
1414 E Walnut St
Seguin, TX 78155-5175
Phone
(830) 379-0299
Fax
(830) 401-0323
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Authorized official

Name
Dr. Jennifer Gaye Hennessee, M.D.
Title
President
Phone
(830) 379-0299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X M1754 TX Primary

Addresses

Primary practice location

1414 E Walnut St
Seguin, TX 78155-5175

Mailing address

PO Box 1266
Seguin, TX 78156-1266
Phone (830) 379-0299

Other identifiers 1

IdentifierTypeStateIssuer
177183401MedicaidTX

National Provider Directory

National Provider Directory

Locations

1339 E Court St
Ste 220
Seguin, TX 78155
Phone (830) 379-0299

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1558461855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1266",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781561266",
            "telephone_number": "830-379-0299",
            "fax_number": "830-401-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E WALNUT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555175",
            "telephone_number": "830-379-0299",
            "fax_number": "830-401-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADALUPE EAR, NOSE AND THROAT, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "HENNESSEE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "GAYE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-379-0299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "M1754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177183401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.