Provider Demographics
NPI:1346656303
Name:GUAJARDO, NATHALIE GUIDRY (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:GUIDRY
Last Name:GUAJARDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 N ED CAREY DR # 1A
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8200
Mailing Address - Country:US
Mailing Address - Phone:956-428-5522
Mailing Address - Fax:
Practice Address - Street 1:2310 N ED CAREY DR # 1A
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8200
Practice Address - Country:US
Practice Address - Phone:956-428-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06029363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant