Glen G.Guillet M.D.,P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

D2455 Issued in TX

Legal business name

GLEN G.GUILLET M.D.,P.A.

Practice address

5875 N Major Dr
Suite 214
Beaumont, TX 77713-9013

Phone

(409) 896-5901

Fax

(409) 896-5910

NPI assigned

May 14, 2007

Last updated

May 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glen G Guillet, M.D.NPI 1326059577

Title

Ceo

Phone

(409) 896-5901

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glen G. Guillet, M.D.

  • Family Medicine Physician
  • Beaumont, TX
  • NPI 1326059577
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1730394545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 N MAJOR DR",
            "address_2": "SUITE 214",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777139013",
            "telephone_number": "409-896-5901",
            "fax_number": "409-896-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 N MAJOR DR",
            "address_2": "SUITE 214",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777139013",
            "telephone_number": "409-896-5901",
            "fax_number": "409-896-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN G.GUILLET M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "GUILLET",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "409-896-5901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "D2455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128065306",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0007PM",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa E. Canzoneri Girod, D.D.S
• Bryan Githumbi, RPH
• Kali Gizzi
• GKH Inc (King's Pharmacy Beaumont)
• GKH Inc (King's Pharmacy Beaumont)
• Brianna Glenn, RBT
• Global Hospice Care Inc (Three Oaks Hospice)
• Global Remnant Behavior Health Services, PLLC
• Lorraine Santos Go, NP
• Robyn Elaina Gobble

• Primary Care Clinic/Center in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.