Provider Demographics
NPI:1851450605
Name:GUY, ROBERT SIDNEY SR (BSPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:SIDNEY
Last Name:GUY
Suffix:SR
Gender:M
Credentials:BSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 BELLEHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5791
Mailing Address - Country:US
Mailing Address - Phone:903-534-8344
Mailing Address - Fax:
Practice Address - Street 1:1302 BELLEHAVEN CT
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5791
Practice Address - Country:US
Practice Address - Phone:903-534-8344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist