Provider Demographics
NPI:1346248523
Name:GUY, ERIC C (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:GUY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 JOY LN
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-7136
Mailing Address - Country:US
Mailing Address - Phone:806-335-0745
Mailing Address - Fax:
Practice Address - Street 1:8300 JOY LN
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-7136
Practice Address - Country:US
Practice Address - Phone:806-335-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142670204Medicaid
TX142670204Medicaid
TXG35616Medicare UPIN