Michael B Guillory, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

F2271 Issued in TX

Practice address

3209 N 4TH St
Suite 100
Longview, TX 75605-5145

Phone

(903) 757-4662

Fax

(903) 757-4665

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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.

• Longview Ophthalmology Associates, PLLC

  • Ophthalmology Physician
  • Longview, TX
  • NPI 1215326772

  Ophthalmology

  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 23, 2010.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1912938754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 N 4TH ST",
            "address_2": "SUITE 100",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055145",
            "telephone_number": "903-757-4662",
            "fax_number": "903-757-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 N 4TH ST",
            "address_2": "SUITE 100",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055145",
            "telephone_number": "903-757-4662",
            "fax_number": "903-757-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F2271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089523702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "826081717",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE LINK",
            "identifier": "2223181",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guadalupe County Hospital Board
• Flor Sostene Guerengomba, PEDIATRICIAN
• Camilo Ernesto Guevara, RN
• Luz Angelica Guevara
• Marisa N. H. Guillory, MD
• Ryan M Guillory, MD
• Carissa Brooke Gunathilaka, LPC
• Gabriella Marie Gunter, CPM
• Lori Guthrie, NP
• Robert Byron Guttry, DDS

• All providers in Longview, TX
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.