Provider Demographics
NPI:1558872952
Name:C. GUY FPS, PLLC
Entity Type:Organization
Organization Name:C. GUY FPS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-405-6163
Mailing Address - Street 1:100 W CENTRAL TEXAS EXPY STE 210
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-7469
Mailing Address - Country:US
Mailing Address - Phone:254-618-4933
Mailing Address - Fax:254-618-1191
Practice Address - Street 1:1129 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:245-845-1221
Practice Address - Fax:254-618-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0727207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty