Provider Demographics
NPI:1760671101
Name:MCGUYER, LAURA LEIGH (RD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEIGH
Last Name:MCGUYER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N BELKNAP ST
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-3415
Mailing Address - Country:US
Mailing Address - Phone:254-965-1581
Mailing Address - Fax:
Practice Address - Street 1:411 N BELKNAP ST
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-3415
Practice Address - Country:US
Practice Address - Phone:254-965-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80430133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered