Provider Demographics
NPI:1417258112
Name:GUY, BEVERLY JO (LVN)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:JO
Last Name:GUY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12310 GREENGLEN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-7253
Mailing Address - Country:US
Mailing Address - Phone:832-887-9022
Mailing Address - Fax:
Practice Address - Street 1:12310 GREENGLEN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-7253
Practice Address - Country:US
Practice Address - Phone:832-887-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186569164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186569OtherLVN