Provider Demographics
NPI:1205229309
Name:GUIDRY, TANGANEKIA
Entity Type:Individual
Prefix:
First Name:TANGANEKIA
Middle Name:
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5815 GREEN FALLS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-4102
Mailing Address - Country:US
Mailing Address - Phone:832-887-2839
Mailing Address - Fax:832-243-6076
Practice Address - Street 1:5815 GREEN FALLS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-4102
Practice Address - Country:US
Practice Address - Phone:832-887-2839
Practice Address - Fax:832-243-6076
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor