Provider Demographics
NPI:1790001543
Name:GUILLORY, PAULA ANNETTE (LSA)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANNETTE
Last Name:GUILLORY
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3025
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77253-3025
Mailing Address - Country:US
Mailing Address - Phone:713-271-2384
Mailing Address - Fax:281-833-8950
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 1610
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-271-2384
Practice Address - Fax:281-833-8950
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00454246ZC0007X
CO118379246ZS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0400XSpecialist/Technologist, OtherSurgical
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant